Exam

Rockall Risk Score

search

Rockall Risk Score, Risk Assessment after Acute Gastrointestinal Hemorrhage

  • See Also
  1. Upper GI Bleeding Score
  2. Upper Gastrointestinal Bleeding
  • Indication
  1. Upper Gastrointestinal Bleeding
  • Criteria
  • Add score from each of the following 5 criteria
  1. Age
    1. Score 0: Age less than 60 years
    2. Score 1: Age 60 to 79 years
    3. Score 2: Age 80 years or older
  2. Shock symptoms
    1. Score 0: Shock absent, normal Heart Rate and Blood Pressure
    2. Score 1: Heart Rate 100 or higher
    3. Score 2: Systolic Blood Pressure <100 mmHg (and Heart Rate 100 or higher)
  3. Comorbidity
    1. Score 0: None
    2. Score 2: CHF, CAD or other major comorbidity
    3. Score 3: Renal Failure, liver failure or metastatic cancer
  4. Endoscopic diagnosis
    1. Score 0: No lesion and no stigmata of recent Hemorrhage (or Mallory-Weiss tear)
    2. Score 1: All other Upper Gastrointestinal Bleeding causes (except upper gastrointestinal cancer)
    3. Score 2: Upper Gastrointestinal Tract cancer
  5. Stigmata of recent Gastrointestinal Bleeding
    1. Score 0: No stigmata or dark spot only
    2. Score 3: Blood in upper GI Tract, adherent clot, visible vessel, or actively bleeding or spurting vessel
  • Interpretation
  • Total cummulative score
  1. Score 0 to 2
    1. Rebleeding rate: 3.5 to 5.3%
    2. Mortality: 0 to 0.2%
  2. Score 3
    1. Rebleeding rate: 11.2%
    2. Mortality: 2.9%
  3. Score 4
    1. Rebleeding rate: 14.1%
    2. Mortality: 5.3%
  4. Score 5
    1. Rebleeding rate: 24.1%
    2. Mortality: 10.8%
  5. Score 6
    1. Rebleeding rate: 32.9%
    2. Mortality: 17.3%
  6. Score 7
    1. Rebleeding rate: 43.8%
    2. Mortality: 27%
  7. Score 8 or higher
    1. Rebleeding rate: 41.8%
    2. Mortality: 41.1%
  • References
  1. Rockall (1996) Gut 38(3):318-9 [PubMed]