Rockall Numerical Risk Scoring System Risk assessment after acute upper gastrointestinal haemorrhage (upper GI bleeding)

Last reviewed 10/2023

The various components of the Rockall Numerical Risk Scoring system are scored individually and then the sum of the component scores is the predictive score:

Age

Shock

Co-morbidity

Initial Rockall Score - out of 7:

0/7 = Predicted mortality 0.2%

1/7 = Predicted mortality 2.4%

2/7 = Predicted mortality 5.6%

3/7 = Predicted mortality 11%

4/7 = Predicted mortality 24.6%

5/7 = Predicted mortality 39.6%

6/7 = Predicted mortality 48.9%

7/7 = Predicted mortality 50%

Additional Criteria for Full Score (after gastroscopy)

This makes total score out of 11

Diagnosis

Major stigmata of recent haemorrhage (SRH)

0/11 = Consider for early discharge (mortality <1% rebleed approx 5%)

1/11 = Consider for early discharge (mortality <1% rebleed approx 5%)

2/11 = Consider for early discharge (mortality <1% rebleed approx 5%)

3/11 = Significant mortality or rebleed risk

4/11 = Significant mortality or rebleed risk

5/11 = Significant mortality or rebleed risk

6/11 = Significant mortality or rebleed risk

7/11 = Significant mortality or rebleed risk

8/11 = Significant mortality or rebleed risk

9/11 = Significant mortality or rebleed risk

10/11 = Significant mortality or rebleed risk

11/11 = Significant mortality or rebleed risk

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 (1)

Reference:

• 1) Vreeburg EM et al.. Validation of the Rockall risk scoring system in upper gastrointestinal bleeding. Gut 1999; 44 (3): 331-5