Shock Index Is a Poor Predictor of Upper GI Bleeding Outcomes

The shock index (SI) is a simple score that is derived by dividing the initial heart rate by the systolic blood pressure. Although a U.K. healthcare quality body has recommended using the SI to risk-stratify patients with upper gastrointestinal bleeding (UGIB), its predictive performance for high-risk outcomes has not been compared with that of existing UGIB risk scores. Now, researchers have made those comparisons in a prospective study among more than 3000 patients with acute UGIB at six large international centers.

The SI was calculated at presentation, as were the Glasgow-Blatchford score (GBS), AIMS65 score, admission Rockall score (ARS), and the international bleeding risk score (i.e., ABC score [age, bloods, comorbidities]). High-risk…