Association of Modified Shock Index with Mortality in Patients with Non-Variceal Upper Gastrointestinal Bleed

Abstract

Abstract Background: In an emergency setting, non-variceal gastrointestinal bleeding in upper region of gastrointestinal tract is the common presentation. Multiple factors interact constantly to maintain the hemodynamic of patients. The modified shock index can help to predict hemodynamic instability and associated outcomes. Objective: To assess the association of modified shock index with mortality within 72 hours in patients of upper gastrointestinal bleed. Methods: This Prospective Cohort study was conducted at Department of Gastroenterology, Services Hospital, Lahore for 6months. Two hundred and eighty patients (140 in each group) were assessed for modified shock index. Two groups were formed i.e. exposed with modified shock index was >1.3 and unexposed with modified shock index was ?1.3. Patients were followed-up in high dependency unit. If patients died within hospital stay, then mortality was labeled. Data was analyzed in SPSS v.20. Relative risk was calculated to measure association between modified shock index with mortality. Results: The mean age of the patients in our study was 52.31 ± 14.22 years in exposed group and 50.69 ± 11.23 years in unexposed group. There were 80 males and 60 females in exposed group while 75 males and 65 females in unexposed group. Among exposed group, mortality occurred in 32 (22.9%) cases while in unexposed group, mortality occurred in 8 (5.7%). Relative Risk was calculated as 1.778 (95% CI; 1.443-2.19). Conclusion: There is significant association of high modified shock index score with mortality. In future, we can now rely on modified shock index for prediction of prognosis of patients with upper gastrointestinal bleed.