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Rockall Score for Acute Upper Gastrointestinal Bleeding

Age
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Age
<60 years
60-79 years
≥80 years
Shock Status
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Shock Status
No shock (systolic BP >100mmHg, heart rate <100bpm)
Tachycardia (systolic BP >100mmHg, heart rate >100bpm)
Hypotension (systolic BP <100mmHg)
Comorbidities
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Comorbidities
None
Heart failure, coronary artery disease, and other severe comorbidities
Liver/kidney failure and disseminated malignancy
Endoscopic Diagnosis
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Endoscopic Diagnosis
Mallory-Weiss syndrome or no lesion and no signs of bleeding
Ulcers and other lesions
Liver/upper gastrointestinal malignancy
Stigmata of Recent Hemorrhage
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Stigmata of Recent Hemorrhage
None or dark spots only
Upper gastrointestinal blood retention, adherent clots, visible vessels, or active bleeding
Score:

Interpretation of Results

The Rockall score can be divided into a preliminary score before endoscopy and a complete score after endoscopy. Different scores correspond to different mortality risks, as shown below:

Score 0 1 2 3 4 5 6 7 8-11
Mortality risk before endoscopy (%) 0.2 2.4 5.6 11.0 24.6 39.6 48.9 50.0
Mortality risk after endoscopy (%) 0 0 0.2 2.9 5.3 10.8 17.3 27.0 41.1

Explanation

The Rockall scoring system is still widely used in clinical practice to assess the risk of rebleeding and mortality in patients with acute gastrointestinal bleeding, especially for its reliability in evaluating mortality risk.

References

Research Paper 1. Guidelines for the diagnosis and treatment of acute non-variceal upper gastrointestinal bleeding (2009, Hangzhou). Chinese Journal of Internal Medicine, October 2009, Vol. 48, No. 10. Research Paper 2. Rockall TA, Logan RF, Devlin HB, Northfield TC. Risk assessment after acute upper gastrointestinal haemorrhage. Gut 1996;38:316-21.
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