Rockall score

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Rockall risk scoring system attempts to identify patients at risk of adverse outcome following acute upper gastrointestinal bleeding. Rockall et al. identified independent risk factors[1] in 1996 which were later shown to predict mortality accurately. The scoring system uses clinical criteria (increasing age, co-morbidity, shock) as well as endoscopic finding (diagnosis, stigmata of acute bleeding). It is named for Professor Tim Rockall, who was the main investigator and first author of the studies that led to its formulation. A convenient mnemonic is ABCDE - i.e. Age, Blood pressure fall (shock), Co-morbidity, Diagnosis and Evidence of bleeding.

Variable[2] Score 0 Score 1 Score 2 Score 3
Age <60 60- 79 >80
Shock No shock Pulse >100
BP >100 Systolic
SBP <100
Co-morbidity Nil major CHF, IHD, major morbidity Renal failure, liver failure, metastatic cancer
Diagnosis Mallory-Weiss All other diagnoses GI malignancy
Evidence of bleeding None Blood, adherent clot, spurting vessel

Interpretation[edit]

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.[3]

See also[edit]

References[edit]

  1. ^ Rockall TA, Logan RF, Devlin HB, Northfield TC (1996). "Risk assessment after acute upper gastrointestinal haemorrhage". Gut. 38 (3): 316–21. doi:10.1136/gut.38.3.316. PMC 1383057Freely accessible. PMID 8675081. 
  2. ^ British Society of Gastroenterology Endoscopy Committee (2002). "Non-variceal upper gastrointestinal haemorrhage: guidelines". Gut. 51 Suppl 4: iv1–6. doi:10.1136/gut.51.suppl_4.iv1. PMC 1867732Freely accessible. PMID 12208839. 
  3. ^ Vreeburg EM, Terwee CB, Snel P, et al. (1999). "Validation of the Rockall risk scoring system in upper gastrointestinal bleeding". Gut. 44 (3): 331–5. doi:10.1136/gut.44.3.331. PMC 1727413Freely accessible. PMID 10026316.