Death Index finds Merchandise frontman Carson Cox collaborating with Italian hardcore veteran Marco Rapisarda for a noisy, industrial-tinged intercontinental project. Even though Cox seems to have become disenchanted with punk, judging by his interviews as well as Merchandise's '80s college rock-leaning After the End, Death Index ends up being some of his hardest, most punk-influenced music yet. Several of the tracks clock in at around two minutes or less, and the fastest, most chaotic ones ("Fast Money Kill" and "Fuori Controllo") are each under a minute. "Dream Machine" has a faster, guitar-driven tempo similar to Ministry. However, other songs are slower and more ritual-like. "The Meal" is midtempo and places the pounding, martial drumming front and center. "Lost Bodies" is a quieter, throbbing Suicide-like electronic dirge with Cox's vocals echoing like rippling waves. "We've Got a Number" returns to a brief song length and punk tempo, but it has a lurching, stilted rhythm before it rushes into a thrashing part at the end. The seven-minute "Patto con Dio" leaves the album at the end of its rope, starting out with hypnotic pounding drums before dissolving into an extended feedback drone, then finally ending with drums crawling away in the background. Lyrically, the entire album is appropriately fixated on death, pain, and dissatisfaction, railing against conformist society and pausing to pay tribute to a fallen hero ("JFK"). Cox's vocals are more of a deep Morrissey croon than a raging punk snarl, so as furious as the songs get, they still seem somewhat dreamy and ethereal rather than raging. The album feels loose, shaky, and combustible, and it is equally paranoid about death as well as obsessed with it.