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]
References
- 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.
- 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. PMC 1867732. PMID 12208839.
- 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.