• Umran Dogru, Melih Yuksel, Mehmet Oguzhan Ay, Halil Kaya, Aksel Ozdemır, Yesim Isler, and Mehtap Bulut.
• MD. Emergency Medicine Specialist, Department of Emergency Medicine, University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey.
• Sao Paulo Med J. 2022 Jul 1; 140 (4): 531-539.

BackgroundGastrointestinal (GI) bleeding is an important cause of mortality and morbidity among geriatric patients.ObjectiveTo investigate whether the shock index and other scoring systems are effective predictors of mortality and prognosis among geriatric patients presenting to the emergency department with complaints of upper GI bleeding.Design And SettingProspective cohort study in an emergency department in Bursa, Turkey.MethodsPatients over 65 years admitted to a single-center, tertiary emergency service between May 8, 2019, and April 30, 2020, and diagnosed with upper GI bleeding were analyzed. 30, 180 and 360-day mortality prediction performances of the shock index and the Rockall, Glasgow-Blatchford and AIMS-65 scores were evaluated.ResultsA total of 111 patients who met the criteria were included in the study. The shock index (P < 0.001) and AIMS-65 score (P < 0.05) of the patients who died within the 30-day period were found to be significantly different, while the shock index (P < 0.001), Rockall score (P < 0.001) and AIMS-65 score (P < 0.05) of patients who died within the 180-day and 360-day periods were statistically different. In the receiver operating characteristic (ROC) analysis for predicting 360-day mortality, the area under the curve (AUC) value was found to be 0.988 (95% confidence interval, CI, 0.971-1.000; P < 0.001).ConclusionThe shock index measured among geriatric patients with upper GI bleeding at admission seems to be a more effective predictor of prognosis than other scoring systems.

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