Rockall score

From WikiMD's Wellness Encyclopedia

Rockall score is a clinical prediction rule that was initially developed to predict the risk of rebleeding in patients who have had a gastrointestinal bleed. It has since been validated as a tool to predict mortality in these patients as well. The score is calculated based on clinical criteria and endoscopic findings.

Clinical Criteria[edit | edit source]

The clinical criteria used in the Rockall score include age, shock, and comorbidity. Each of these factors is assigned a score, with higher scores indicating a higher risk of rebleeding or death.

  • Age: Patients under the age of 60 are assigned a score of 0, those between 60 and 79 are assigned a score of 1, and those 80 and older are assigned a score of 2.
  • Shock: The presence of shock is assessed based on the patient's heart rate and systolic blood pressure. Patients with a heart rate under 100 and a systolic blood pressure over 100 are assigned a score of 0, those with a heart rate over 100 or a systolic blood pressure between 100 and 89 are assigned a score of 1, and those with a systolic blood pressure under 90 are assigned a score of 2.
  • Comorbidity: The presence of comorbidities is also considered. Patients with no major comorbidity are assigned a score of 0, those with heart failure, ischemic heart disease, or any major comorbidity are assigned a score of 2, and those with renal failure, liver failure, or disseminated malignancy are assigned a score of 3.

Endoscopic Findings[edit | edit source]

The endoscopic findings used in the Rockall score include the diagnosis and the presence of major stigmata of recent hemorrhage. Each of these factors is assigned a score, with higher scores indicating a higher risk of rebleeding or death.

  • Diagnosis: The diagnosis is based on the findings of the endoscopy. Patients with no lesion or with Mallory-Weiss tear are assigned a score of 0, those with all other diagnoses are assigned a score of 1, and those with malignancy are assigned a score of 2.
  • Major Stigmata of Recent Hemorrhage: The presence of major stigmata of recent hemorrhage is also considered. Patients with none are assigned a score of 0, and those with blood in the upper gastrointestinal tract, adherent clot, visible or spurting vessel are assigned a score of 2.

Interpretation[edit | edit source]

The total Rockall score ranges from 0 to 11, with higher scores indicating a higher risk of rebleeding or death. A score of 0 indicates a very low risk, while a score of 11 indicates a very high risk.

See Also[edit | edit source]

Rockall score Resources
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Contributors: Prab R. Tumpati, MD