Rockall score explained

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

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 0Score 1Score 2Score 3
Age<6060- 79>80
ShockNo shockPulse >100
BP >100 Systolic
SBP <100
Co-morbidityNil majorCHF, IHD, major morbiditykidney failure, liver failure, metastatic cancer
DiagnosisMallory-WeissAll other diagnosesGI malignancy
Evidence of bleedingNoneBlood, adherent clot, spurting vessel

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

Notes and References

  1. Rockall TA, Logan RF, Devlin HB, Northfield TC . Risk assessment after acute upper gastrointestinal haemorrhage . Gut . 38 . 3 . 316–21 . 1996 . 8675081 . 10.1136/gut.38.3.316 . 1383057.
  2. Non-variceal upper gastrointestinal haemorrhage: guidelines . Gut . 51 Suppl 4 . iv1–6 . 2002 . 12208839 . 10.1136/gut.51.suppl_4.iv1 . British Society of Gastroenterology Endoscopy Committee . Suppl 4 . 1867732.
  3. Vreeburg EM, Terwee CB, Snel P, etal . Validation of the Rockall risk scoring system in upper gastrointestinal bleeding . Gut . 44 . 3 . 331–5 . 1999 . 10026316 . 10.1136/gut.44.3.331. 1727413.