What is the Rockall Score?

The Rockall Score is a validated clinical tool for risk-stratifying patients with acute upper gastrointestinal (GI) bleeding. It predicts the risk of rebleeding and in-hospital mortality based on age, shock, comorbidities, and endoscopic findings.

What is the difference between pre- and post-endoscopy scores?

The pre-endoscopy Rockall score uses only clinical data (age, shock, comorbidities) and ranges from 0 to 7. The full post-endoscopy score adds endoscopic findings (diagnosis and stigmata of recent hemorrhage), raising the maximum to 11. Post-endoscopy scores are more accurate for risk prediction.

What score indicates low risk?

A score of 0 carries very low rebleed risk (~5%) and near-zero mortality. Scores of 0–1 are generally considered low risk and may be suitable for early discharge or outpatient management. Scores ≥ 5 indicate high risk with significant rebleed risk and mortality.

Does this replace clinical judgment?

No. The Rockall Score is a decision support tool. Clinical judgment, local protocols, and patient-specific factors must guide final management decisions.

Which conditions count as major comorbidities?

Renal failure, liver failure, and disseminated malignancy each score 3 points and represent the highest-risk comorbidity category. Cardiac failure, ischemic heart disease, and any other major comorbidity score 2 points.

Rockall GI Bleed Score Calculator — Rebleed & Mortality Risk

Summary

Score upper GI bleeding severity using the Rockall system to predict rebleeding risk and mortality — pre- or post-endoscopy.

How it works

Select the patient age group and presence of hemodynamic shock.
Choose the relevant comorbid conditions from the list.
If endoscopy has been performed, add the endoscopic findings.
The score updates instantly and maps to a risk category.
Use the risk table to guide clinical decisions on discharge vs. intensive monitoring.

Use cases

Triage patients with acute upper GI bleeding in the emergency department.
Decide which patients can be safely discharged early (score 0–1).
Identify high-risk patients who need ICU admission or urgent endoscopy.
Communicate rebleed and mortality risk clearly between clinical teams.
Support endoscopy timing decisions using the pre-endoscopy component.

Rockall GI Bleed Score

Clinical Parameters

Rockall Score

Score Reference