Rockall score

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] in 1996 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). It is named for Professor Tim Rockall, who was the main investigator and first author of the studies that led to its formulation. A convenient mnemonic is ABCDE - i.e. Age, Blood pressure fall (shock), Co-morbidity, Diagnosis and Evidence of bleeding.

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

Rockall score
Test of	assess after GI bleeding(for adverse outcome)

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]

See also

• Forrest classification
• Glasgow-Blatchford

References

1. Rockall TA, Logan RF, Devlin HB, Northfield TC (1996). "Risk assessment after acute upper gastrointestinal haemorrhage". Gut. 38 (3): 316–21. doi:10.1136/gut.38.3.316. PMC 1383057. PMID 8675081.
2. British Society of Gastroenterology Endoscopy Committee (2002). "Non-variceal upper gastrointestinal haemorrhage: guidelines". Gut. 51 Suppl 4: iv1–6. doi:10.1136/gut.51.suppl_4.iv1 (inactive 2021-01-10). PMC 1867732. PMID 12208839.CS1 maint: DOI inactive as of January 2021 (link)
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. doi:10.1136/gut.44.3.331. PMC 1727413. PMID 10026316.