Rockall Score

Predict rebleeding and mortality after upper GI bleeding. Pre-endoscopy uses the first 3 variables; post-endoscopy adds diagnosis and stigmata.

Indication

Predict rebleeding and mortality after upper GI bleeding. Pre-endoscopy uses the first 3 variables; post-endoscopy adds diagnosis and stigmata.

id: age; label: Age; type: options; options: value: 0; label: <60; value: 1; label: 60–79; value: 2; label: ≥80
id: shock; label: Shock; type: options; options: value: 0; label: No shock (SBP ≥100, HR <100); value: 1; label: Tachycardia (SBP ≥100, HR ≥100); value: 2; label: Hypotension (SBP <100)
id: comorbidity; label: Comorbidity; type: options; options: value: 0; label: None; value: 2; label: Cardiac failure, IHD, or major comorbidity; value: 3; label: Renal failure, liver failure, or metastatic cancer
id: diagnosis; label: Endoscopic diagnosis (post-endoscopy); type: options; options: value: 0; label: Mallory-Weiss tear or no lesion; value: 1; label: All other diagnoses; value: 2; label: Malignancy of upper GI tract
id: stigmata; label: Stigmata of recent hemorrhage (post-endoscopy); type: options; options: value: 0; label: None or dark spot only; value: 2; label: Blood, adherent clot, visible or spurting vessel

GBS is better for initial triage (predicts need for intervention); Rockall is better post-endoscopy for rebleed and mortality
Pre-endoscopy Rockall uses age, shock, and comorbidity only
Combined use of GBS and Rockall provides comprehensive risk stratification
Post-endoscopy score is more accurate than the pre-endoscopy score