Rockall Score Calculator (Upper GI Bleeding)

How it works

Pre-endoscopy Rockall = age (0–2) + shock (0–2) + comorbidity (0/2/3); range 0–7. Complete Rockall = pre-endoscopy score + diagnosis (0–2) + stigmata of recent haemorrhage (0/2); range 0–11. Complete score ≤ 2 low risk · ≥ 8 high risk.

The Rockall score (Rockall, Logan, Devlin and Northfield, 1996) was developed from a UK national audit of more than 4,000 patients to predict death after acute upper gastrointestinal bleeding. The clinical (pre-endoscopy) part uses age, shock and comorbidity; endoscopy adds the diagnosis and the stigmata of recent haemorrhage. A complete score of 2 or less identifies patients at low risk of rebleeding and death who may be suitable for early discharge, while scores of 8 or more carried about 41% mortality in the original cohort. Guidelines now prefer the Glasgow-Blatchford score before endoscopy to identify patients who can be managed as outpatients.

Worked example

A 70-year-old (1) with pulse 108 and systolic pressure 118 mmHg (1) and ischaemic heart disease (2), whose endoscopy shows a peptic ulcer (1) with only a clean base (0): complete Rockall = 1 + 1 + 2 + 1 + 0 = 5 / 11 — intermediate risk, with 10.8% mortality in the original study.

Sources: Rockall TA, Logan RF, Devlin HB, Northfield TC. Risk assessment after acute upper gastrointestinal haemorrhage. Gut 1996

Frequently asked questions