Rockall Score Calculator (Pre-Endoscopic)

The Rockall score (Rockall TA et al., Gut, 1996) is a clinical scoring system that predicts mortality and rebleeding in patients with upper gastrointestinal bleeding. Two versions exist: the pre-endoscopic (clinical) score and the full Rockall score (post-endoscopy, incorporating bleeding stigmata).

The pre-endoscopic Rockall score uses age, shock (HR, BP), and comorbidities. The full score adds the endoscopic diagnosis and Forrest stigmata of bleeding. The pre-endoscopic score ranges from 0 to 7, the full score from 0 to 11. Low risk (≤ 2 pre-endoscopic, ≤ 3 full) corresponds to mortality < 1% and identifies candidates for early discharge.

An alternative, and more widely used, tool is the Glasgow-Blatchford Score (GBS), which is even better at identifying "low risk" patients (GBS = 0 — near 0% mortality). Clinical guidelines for upper GI bleeding recognize both scores as standard practice. In practice, GBS is often used before endoscopy, with Rockall applied to assess the risk of rebleeding afterward.

• Admission of a patient with upper GI bleeding — pre-endoscopic Rockall for triage.
• After EGD — full Rockall score to assess rebleeding risk and guide discharge decisions.
• Deciding the level of monitoring (ICU vs ward vs early discharge).
• Documenting medical necessity for admission for insurance purposes.

• Sensitivity for rebleeding is moderate — always interpret in clinical context.
• The pre-endoscopic version is less accurate than GBS for identifying low-risk patients.
• Not validated for lower GI bleeding.
• Comorbidity categories are broad and subject to subjective judgment.