Clinical Overview
The Rockall Score is an essential tool in gastroenterology and emergency medicine. Acute upper gastrointestinal bleeding (AUGIB) carries a high mortality rate. The Rockall score helps clinicians identify which patients are at high risk of rebleeding or death, thereby requiring ICU admission or urgent endoscopic/surgical intervention.
Pathophysiology & Evidence
The score accounts for the physiological reserve of the patient (Age, Comorbidities) and the severity of the acute blood loss (Shock/Tachycardia). During endoscopy, finding a "visible vessel" or "spurting arterial bleed" (high stigmata scores) indicates a massive risk of rebleeding compared to a clean-based ulcer.
Formula Breakdown
Score = Age + Shock + Comorbidities + Diagnosis + Endoscopic Stigmata
A full score of 0-2 suggests a low risk of death and rebleeding, often allowing for early hospital discharge. Scores of 8 or higher indicate a mortality risk exceeding 40%.