Investigation of the Relationship Between Shock Index, Scores in Patients with Upper Gastrointestinal Bleeding

IF 1.6 4区医学 Q3 EMERGENCY MEDICINE

Journal of Emergency Medicine Pub Date : 2025-12-01 Epub Date: 2025-11-30 DOI:10.1016/j.jemermed.2025.10.043

Bahadir Taslidere, Julide Gurbuz, Elif Betul Balci, Emre Kalkan, Basar Cander

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引用次数: 0

Abstract

Background

Upper gastrointestinal bleeding (UGIB) is a common and life-threatening emergency with a mortality rate of 2–8%. Although prognostic assessment often relies on the Glasgow-Blatchford Score (GBS) and Rockall Score (RS), their inclusion of multiple parameters limits use in acute settings. The shock index (SI), derived from heart rate and systolic blood pressure, provides a simple and rapid alternative. This study investigates the relationship between the SI and established risk scores (GBS and RS) in patients with UGIB.

Methods

This retrospective study included patients over 18 years of age who presented to the emergency department between January 1 and December 31, 2021. Of the 246 patients who underwent endoscopy, 106 were excluded due to variceal bleeding, pregnancy, incomplete or missing data, loss to follow-up, referral, or trauma. Clinical and laboratory information, including endoscopic findings, laboratory results, treatment details, and clinical follow-up, were collected. GBS, RS, and SI were calculated for each patient to evaluate the effectiveness of the SI in UGIB by examining its relationship with the GBS and RS.

Result

We enrolled 140 patients (62.9% male, n = 88; 37.1% female, n = 52). The mean age was comparable between the low and high SI groups (57.08 ± 20.20 vs. 54.75 ± 18.67 years, p = 0.482). Female patients had a significantly higher mean age than males (p < 0.001). The high SI group demonstrated significantly higher GBS scores compared with the low SI group (9.26 ± 3.50 vs. 6.29 ± 3.47, p < 0.001). The mean RS was significantly higher in the high SI group compared with the low SI group (4.42 ± 2.11 vs. 3.30 ± 2.20, p = 0.003).

Conclusions

In our study, both GBS and RS were significantly higher in patients with elevated SI, indicating that the Shock Index closely reflects bleeding severity and hemodynamic instability. Given that SI can be calculated rapidly, at no cost, and without the need for laboratory data, it may provide an early estimate of bleeding severity and prognosis before more comprehensive scoring systems such as GBS or RS are determined in the emergency department.

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上消化道出血患者休克指数与评分关系的探讨

背景：十二指肠出血（UGIB）是一种常见的危及生命的急症，死亡率为2-8%。尽管预后评估通常依赖于格拉斯哥-布拉奇福德评分（GBS）和罗克尔评分（RS），但它们包含的多个参数限制了在急性情况下的使用。由心率和收缩压得出的休克指数（SI）提供了一个简单而快速的替代方法。本研究探讨了UGIB患者SI与既定风险评分（GBS和RS）之间的关系。方法本回顾性研究纳入了2021年1月1日至12月31日在急诊科就诊的18岁以上患者。在246例接受内窥镜检查的患者中，106例因静脉曲张出血、妊娠、数据不完整或缺失、随访缺失、转诊或创伤而被排除在外。收集临床和实验室信息，包括内镜检查结果、实验室结果、治疗细节和临床随访。计算每位患者的GBS、RS和SI，通过检查其与GBS和RS的关系来评估SI在UGIB中的有效性。结果纳入140例患者，其中男性62.9%,n = 88；女性37.1%,n = 52)。低SI组和高SI组的平均年龄具有可比性（57.08±20.20∶54.75±18.67岁，p = 0.482）。女性患者的平均年龄明显高于男性（p < 0.001）。高SI组的GBS评分明显高于低SI组（9.26±3.50比6.29±3.47,p < 0.001）。高SI组的平均RS显著高于低SI组（4.42±2.11∶3.30±2.20,p = 0.003）。结论在我们的研究中，SI升高的患者GBS和RS均明显升高，表明休克指数密切反映出血严重程度和血流动力学不稳定。考虑到SI可以快速计算，不需要成本，不需要实验室数据，它可以在急诊科确定更全面的评分系统（如GBS或RS）之前提供出血严重程度和预后的早期估计。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Emergency Medicine 医学-急救医学

CiteScore

2.40

自引率

6.70%

发文量

339

审稿时长

2-4 weeks

期刊介绍： The Journal of Emergency Medicine is an international, peer-reviewed publication featuring original contributions of interest to both the academic and practicing emergency physician. JEM, published monthly, contains research papers and clinical studies as well as articles focusing on the training of emergency physicians and on the practice of emergency medicine. The Journal features the following sections: • Original Contributions • Clinical Communications: Pediatric, Adult, OB/GYN • Selected Topics: Toxicology, Prehospital Care, The Difficult Airway, Aeromedical Emergencies, Disaster Medicine, Cardiology Commentary, Emergency Radiology, Critical Care, Sports Medicine, Wound Care • Techniques and Procedures • Technical Tips • Clinical Laboratory in Emergency Medicine • Pharmacology in Emergency Medicine • Case Presentations of the Harvard Emergency Medicine Residency • Visual Diagnosis in Emergency Medicine • Medical Classics • Emergency Forum • Editorial(s) • Letters to the Editor • Education • Administration of Emergency Medicine • International Emergency Medicine • Computers in Emergency Medicine • Violence: Recognition, Management, and Prevention • Ethics • Humanities and Medicine • American Academy of Emergency Medicine • AAEM Medical Student Forum • Book and Other Media Reviews • Calendar of Events • Abstracts • Trauma Reports • Ultrasound in Emergency Medicine