What is the maximum possible Rockall score?

The maximum pre-endoscopy Rockall score is 7 (age ≥ 80 = 2, hypotension shock = 2, renal/hepatic failure or malignancy = 3). Adding endoscopic findings raises the ceiling to 11 (post-endoscopy) by adding up to 2 points for GI malignancy and 2 points for major stigmata of recent hemorrhage.

What score is considered low risk?

Scores of 0 or 1 are low risk with rebleed rates below 5% and near-zero mortality. Published guidelines and the original Rockall paper support considering early discharge or outpatient endoscopy for patients scoring 0–1, provided they are hemodynamically stable and have no other complicating factors.

What are "stigmata of recent hemorrhage"?

Stigmata of recent hemorrhage (SRH) are endoscopic signs that indicate recent active bleeding or high rebleed risk: active spurting arterial bleeding, a non-bleeding visible vessel, an adherent blood clot, or blood in the upper GI tract. A dark spot or clean base carries zero points in the Rockall system.

How does the Rockall score compare to the Glasgow-Blatchford Score?

The Glasgow-Blatchford Score (GBS) uses only pre-endoscopy clinical and laboratory variables and excels at identifying patients who need intervention (transfusion, endoscopic hemostasis, surgery). The Rockall score is better studied for predicting rebleeding and mortality after endoscopy. Most centers use both — GBS to determine need for admission and early endoscopy, Rockall to quantify post-procedure risk.

Which comorbidities score highest?

Renal failure, liver failure (including cirrhosis), and disseminated malignancy each score 3 points — the highest comorbidity tier. Cardiac failure, ischemic heart disease (IHD), or any other major comorbidity score 2 points. Absence of significant comorbidities scores 0.

Is this tool a substitute for clinical judgment?

No. This calculator is for educational purposes only. The Rockall score is a decision-support aid; final triage, endoscopy timing, and discharge decisions must be made by qualified clinicians based on the full clinical picture, local protocols, and patient-specific factors.

Rockall Score (Detailed) — Full Pre & Post-Endoscopy Calculator

Score	Risk	Rebleed	Mortality	Suggested Action
0	Very Low	4.9%	0%	Consider early discharge; outpatient endoscopy
1	Low	3.4%	0%	Observation; early discharge if stable
2	Low	5.3%	0.2%	Inpatient; elective endoscopy within 24 h
3	Moderate	11.2%	2.9%	Admit; endoscopy and close monitoring
4	Moderate	14.1%	5.3%	Inpatient monitoring with endoscopy
5	High	24.1%	10.8%	HDU; early therapeutic endoscopy
6	High	32.9%	17.3%	ICU; urgent endoscopy required
≥ 7	Very High	43–49%	27–49%	ICU; emergent endoscopy; surgical backup

Summary

Enter clinical and endoscopic variables to compute the full Rockall score with per-point rebleed and mortality estimates for upper GI bleeding.

How it works

Select the patient's age group from the three options (< 60, 60–79, or ≥ 80 years).
Choose the shock status based on systolic blood pressure and heart rate at presentation.
Select the highest-risk comorbidity present (none, cardiac/IHD/other major, or renal/hepatic failure/malignancy).
If endoscopy has been performed, enable the endoscopic fields and select the diagnosis and stigmata of recent hemorrhage.
The score calculates instantly with the pre-endoscopy total shown as the baseline; enabling endoscopy fields switches to the full post-endoscopy score.
Review the per-variable point breakdown and the risk table row that matches the computed score.

Use cases

Triage patients presenting to the emergency department with hematemesis, melena, or coffee-ground emesis.
Decide on ICU versus general ward admission before endoscopy using the pre-endoscopy score.
Identify low-risk patients (score 0–1) who may be suitable for early discharge or outpatient endoscopy.
Quantify post-endoscopy rebleed and mortality risk to guide intensity of monitoring and intervention.
Communicate objective risk estimates during handover between emergency, gastroenterology, and surgical teams.
Support clinical research and audit of upper GI bleeding outcomes using a standardized scoring system.

Rockall Score (Detailed)

Clinical Variables

Rockall Score

Rockall Score Reference Table