Rockall score - Misplaced Pages

System for assessing risks after gastrointestinal bleeding Medical diagnostic method

Rockall score
Test of	assess after GI bleeding(for adverse outcome)

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 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	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	kidney failure, liver failure, metastatic cancer
Diagnosis	Mallory-Weiss	All other diagnoses	GI malignancy
Evidence of bleeding	None		Blood, adherent clot, spurting vessel

Interpretation

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.

References

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 1383057. PMID 8675081.
British Society of Gastroenterology Endoscopy Committee (2002). "Non-variceal upper gastrointestinal haemorrhage: guidelines". Gut. 51 Suppl 4 (Suppl 4): iv1–6. doi:10.1136/gut.51.suppl_4.iv1. PMC 1867732. PMID 12208839.
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 1727413. PMID 10026316.

Diseases of the human digestive system

Upper GI tract

Esophagus

Stomach

Lower GI tract
Enteropathy

Small intestine (Duodenum/Jejunum/Ileum)	Enteritis Duodenitis Jejunitis Ileitis Peptic (duodenal) ulcer Curling's ulcer Malabsorption: Coeliac Tropical sprue Blind loop syndrome Small intestinal bacterial overgrowth Whipple's Short bowel syndrome Steatorrhea Milroy disease Bile acid malabsorption
Large intestine (Appendix/Colon)	Appendicitis Colitis Pseudomembranous Ulcerative Ischemic Microscopic Collagenous Lymphocytic Dysentery Functional colonic disease IBS Intestinal pseudoobstruction / Ogilvie syndrome Megacolon / Toxic megacolon Diverticulitis/Diverticulosis/SCAD
Large and/or small	Enterocolitis Necrotizing Gastroenterocolitis IBD Crohn's disease Vascular: Abdominal angina Mesenteric ischemia Angiodysplasia Bowel obstruction: Ileus Intussusception Volvulus Fecal impaction Constipation Functional Diarrhea Infectious Intestinal adhesions
Rectum	Proctitis Radiation proctitis Proctalgia fugax Rectal prolapse Anismus Solitary rectal ulcer syndrome Rectal stricture
Anal canal	Anal fissure/Anal fistula Anal abscess Hemorrhoid Anal dysplasia Pruritus ani Anal stricture

GI bleeding

Accessory

Liver	Hepatitis Viral hepatitis Autoimmune hepatitis Alcoholic hepatitis Cirrhosis PBC Fatty liver MASLD Vascular Budd–Chiari syndrome Hepatic veno-occlusive disease Portal hypertension Nutmeg liver Alcoholic liver disease Liver failure Hepatic encephalopathy Acute liver failure Liver abscess Pyogenic Amoebic Hepatorenal syndrome Peliosis hepatis Metabolic disorders Wilson's disease Hemochromatosis
Gallbladder	Cholecystitis Gallstone / Cholelithiasis Cholesterolosis Adenomyomatosis Postcholecystectomy syndrome Porcelain gallbladder
Bile duct/ Other biliary tree	Cholangitis Primary sclerosing cholangitis Secondary sclerosing cholangitis Ascending Cholestasis/Mirizzi's syndrome Biliary fistula Haemobilia Common bile duct Choledocholithiasis Biliary dyskinesia Sphincter of Oddi dysfunction
Pancreatic	Pancreatitis Acute Chronic Hereditary Pancreatic abscess Pancreatic pseudocyst Exocrine pancreatic insufficiency Pancreatic fistula

Other

Hernia

Lumbar
- Petit's
- Grynfeltt–Lesshaft

Undefined location

Peritoneal

Categories:

Interpretation

See also

References