Determining the Predictive Value of Shock Index, Reverse Shock Index, and Modified Shock Index in Hospital Outcome of Gastrointestinal Bleeding in Elderly Patients

Objectives: To investigate the predictive value of the shock index (SI), reverse shock index (RSI), and modified shock index (MSI) in determining the hospital outcomes of elderly patients with gastrointestinal bleeding (GIB). Design: A cross-sectional study. Settings: The study was carried out in Tabriz, East Azarbaijan, North-west Iran. Participants: The study included patients aged over 75 years who were presented with acute upper GIB. Outcome Measures: Specificity, sensitivity, positive, and negative predictive values were calculated to assess the predictive capacity of these three indices in predicting mortality risk among patients as their in-hospital outcome. Results: Age distribution among the patients in this study did not follow a normal pattern. Regarding the predictive value of the SI, RSI, and MSI for patient outcomes, the sensitivity and specificity of these criteria were as follows: SI with 48.48% sensitivity and 86.84% specificity (95% CI: 79.23-92.44), RSI with 33.33% sensitivity and 92.04% specificity (95% CI: 85.42-96.29), and MSI with 30.30% sensitivity and 91.23% specificity (95% CI: 84.46-95.71). Conclusions: The findings of this study indicated that none of these criteria effectively predicted mortality in patients with GIB. However, SI, RSI, and MSI exhibited high specificity in predicting hospital outcomes for GIB patients, making them valuable tools for ruling out life-threatening conditions. However, due to their low sensitivity, they are less reliable for diagnostic purposes in determining the specific causes of GIB.