Rockall score

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]


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Rockall risk scoring system attempts to identify patients at risk of adverse outcome following acute upper gastrointestinal bleeding. Rockall et al identified independent risk factors[1] which were later shown to predict mortality accurately. The scoring system uses clinical criteria ( increasing age, co-morbidity, shock) as well as endoscopic finding (diagnosis, stigmata of acute bleeding).

Variable[2] Score 0 Score 1 Score 2 Score 3
Age <60 60- 79 >80
Shock No shock Pulse >100 SBP <100
Comorbidity Nil major CCF, IHD, major morbidity Renal failure, liver failure, metastatic cancer
Diagnosis Mallory-weiss All other diagnoses GI malignancy
Evidence of bleeding None Blood, adherent clot, spurting vessel

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Interpretation

Total score is calculated by simple addition. A score less than 3 carries good prognosis but total score more than 8 carries high risk of mortality[3].

References

  1. Rockall TA, Logan RF, Devlin HB, Northfield TC (1996). "Risk assessment after acute upper gastrointestinal haemorrhage". Gut. 38 (3): 316–21. PMID 8675081.
  2. "Non-variceal upper gastrointestinal haemorrhage: guidelines". Gut. 51 Suppl 4: iv1–6. 2002. PMID 12208839.
  3. Vreeburg EM, Terwee CB, Snel P; et al. (1999). "Validation of the Rockall risk scoring system in upper gastrointestinal bleeding". Gut. 44 (3): 331–5. PMID 10026316.




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