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Rockall score after upper GI bleed

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

The various components of the Rockall Numerical Risk Scoring system are scored individually and then the sum of the component scores is the predictive score:

Age

Age < 60y

0 points

Age 60-79y

1 point

Age >= 80y

2 points

Shock

No 'shock' (SBP <=100mmHg, HR <=100)

0 points

'Tachycardia' (SBP >= 100 mmHg, HR > =100)

1 point

'Hypotension' (SBP < 100mmHg)

2 points

Co-morbidity

No major co-morbidity

0 points

Cardiac failure, IHD or any major co-morbidity

2 points

renal failure, liver failure, or metastatic disease

3 points

Initial Rockall Score - out of 7:

0/7 = Predicted mortality 0.2%

1/7 = Predicted mortality 2.4%

2/7 = Predicted mortality 5.6%

3/7 = Predicted mortality 11%

4/7 = Predicted mortality 24.6%

5/7 = Predicted mortality 39.6%

6/7 = Predicted mortality 48.9%

7/7 = Predicted mortality 50%

Additional Criteria for Full Score (after gastroscopy)

This makes total score out of 11

Diagnosis

Mallory-Weiss tear, no lesion seen nor SRH (stigmata of recent haemorrhage)

0 points

All other diagnoses apart from GI malignancy

1 point

GI malignancy

2 points

Major stigmata of recent haemorrhage (SRH)

None or dark spot only

0 points

Blood, adherent clot, spurting vessel

2 point

0/11 = Consider for early discharge (mortality <1% rebleed approx 5%)

1/11 = Consider for early discharge (mortality <1% rebleed approx 5%)

2/11 = Consider for early discharge (mortality <1% rebleed approx 5%)

3/11 = Significant mortality or rebleed risk

4/11 = Significant mortality or rebleed risk

5/11 = Significant mortality or rebleed risk

6/11 = Significant mortality or rebleed risk

7/11 = Significant mortality or rebleed risk

8/11 = Significant mortality or rebleed risk

9/11 = Significant mortality or rebleed risk

10/11 = Significant mortality or rebleed risk

11/11 = Significant mortality or rebleed risk

 

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 (1)

Reference:

 


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