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    Patent Pending

    Rockall Score for Upper GI Bleeding (Complete)

    Determines severity of GI bleeding.

    INSTRUCTIONS

    Use this score for known upper GI bleed patients with a completed endoscopy. Use the Pre-Endoscopy Rockall Score for patients who have not yet had endoscopy.
    When to Use
    Pearls/Pitfalls
    Why Use

    Patients with clinical upper GI bleeding who have undergone endoscopy.

    • The complete Rockall Score estimates mortality in patients with active upper GI bleed who have had endoscopy.
    • Use the pre-endoscopy Rockall Score for patients with upper GI bleed who have not undergone endoscopy.
    • The Rockall Score is supported by multiple validation studies, most showing moderate prediction of death at higher risk.
    • It can predict very low risk patients, but with less accuracy.
    • The complete Rockall Score is calculated based on clinical bleeding AND endoscopy results.
    • Upper GI bleeding may present in different degrees of severity, from minor bleeding that can be managed outpatient to severe, life-threatening hemorrhage.
    • The complete Rockall Score can help stratify which patients need endoscopy and intensive care. It is less accurate at identifying low-risk patients (e.g. those who may be treated as outpatients).
    <60 years
    0
    60-79 years
    +1
    ≥80 years
    +2
    No shock (SBP ≥100 AND HR <100)
    0
    Tachycardia (SBP ≥100 AND HR ≥100)
    +1
    Hypotension (SBP <100)
    +2
    No major comorbidity
    0
    Any comorbidity EXCEPT renal failure, liver failure, and/or disseminated malignancy
    +2
    Renal failure, liver failure, and/or disseminated malignancy
    +3
    Mallory-Weiss tear
    0
    No lesion identified and no stigmata of recent hemorrhage
    0
    All other diagnoses
    +1
    Malignancy of upper GI tract
    +2
    None
    0
    Dark spot only
    0
    Blood in upper GI tract
    +2
    Adherent clot
    +2
    Visible or spurting vessel
    +2

    Result:

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    Next Steps
    Evidence
    Creator Insights
    Dr. Timothy Rockall

    About the Creator

    Timothy Rockall, MD, is a consultant surgeon at the Royal Surrey County Hospital in Guildford. He specializes in gastrointestinal surgery and the management of colorectal disease. He has a particular interest in the development and practice of laparoscopic surgery and has developed an international reputation in the practice of laparoscopic resection for colorectal disease including bowel cancer. Dr. Rockall is also the creator of the Complete Rockall Score for Upper GI Bleeding.

    To view Dr. Timothy Rockall's publications, visit PubMed

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    MDCalc loves calculator creators – researchers who, through intelligent and often complex methods, discover tools that describe scientific facts that can then be applied in practice. These are real scientific discoveries about the nature of the human body, which can be invaluable to physicians taking care of patients.
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