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
Age < 60y | 0 points |
Age 60-79y | 1 point |
Age >= 80y | 2 points |
Shock
No 'shock' (SBP <=100mmHg, HR <=100) | 0 points |
'Tachycardia' (SBP >= 100 mmHg, HR > =100) | 1 point |
'Hypotension' (SBP < 100mmHg) | 2 points |
Co-morbidity
No major co-morbidity | 0 points |
Cardiac failure, IHD or any major co-morbidity | 2 points |
renal failure, liver failure, or metastatic disease | 3 points |
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
Mallory-Weiss tear, no lesion seen nor SRH (stigmata of recent haemorrhage) | 0 points |
All other diagnoses apart from GI malignancy | 1 point |
GI malignancy | 2 points |
Major stigmata of recent haemorrhage (SRH)
None or dark spot only | 0 points |
Blood, adherent clot, spurting vessel | 2 point |
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:
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