Rockall Score Calculator for Upper GI Bleeding
Estimate the risk of rebleeding and death after an acute upper gastrointestinal bleed with the Rockall score. Three clinical items — age, shock and comorbidity — give the pre-endoscopy score (0–7); adding the endoscopic diagnosis and stigmata of recent haemorrhage gives the complete score (0–11). Select the findings that apply.
About the Rockall score
The Rockall score risk-stratifies acute upper gastrointestinal bleeding for rebleeding and death. Source: Rockall TA et al., “Risk assessment after acute upper gastrointestinal haemorrhage,” Gut 1996;38(3):316–321. Compare with the Glasgow-Blatchford score, which needs no endoscopy.
How this is calculated
| Factor | Points |
|---|---|
| Age: < 60 / 60–79 / ≥ 80 | 0 / 1 / 2 |
| Shock: none / tachycardia / hypotension | 0 / 1 / 2 |
| Comorbidity: none / cardiac or major / renal-liver-metastatic | 0 / 2 / 3 |
| Diagnosis: Mallory-Weiss or none / other / malignancy | 0 / 1 / 2 |
| Stigmata: none or dark spot / blood, clot or vessel | 0 / 2 |
| Maximum (pre-endoscopy 7) | 11 |
Add the points for each item. Complete score ≤ 2 low, 3–7 intermediate, ≥ 8 high. Approximate mortality: 0% (≤1), 0.2% (2), 2.9% (3), 5.3% (4), 10.8% (5), 17.3% (6), 27% (7), ≈ 41% (8+). Source: Rockall TA et al., Gut 1996;38(3):316–321.
Frequently asked questions
What is the difference between the pre-endoscopy and complete Rockall score?
The pre-endoscopy (clinical) score uses only age, shock and comorbidity, for a maximum of 7, and can be worked out on admission before endoscopy. The complete score adds the endoscopic diagnosis and the stigmata of recent haemorrhage, for a maximum of 11. This calculator shows both: the complete score as the headline, and the pre-endoscopy subscore separately so it is usable before the scope.
How is each Rockall item scored?
Age: under 60 = 0, 60–79 = 1, 80 or over = 2. Shock: none (pulse under 100 and systolic BP 100 or more) = 0, tachycardia (pulse 100 or more, systolic 100 or more) = 1, hypotension (systolic under 100) = 2. Comorbidity: none major = 0, cardiac failure/ischaemic heart disease/other major = 2, renal failure/liver failure/metastatic cancer = 3. Diagnosis at endoscopy: Mallory-Weiss or no lesion = 0, all other diagnoses = 1, upper-GI malignancy = 2. Stigmata: none or dark spot = 0, blood in the upper GI tract, adherent clot or a visible/spurting vessel = 2.
What mortality does the complete Rockall score predict?
In the original derivation the mortality rose with the complete score: roughly 0% at 0–1, 0.2% at 2, 2.9% at 3, 5.3% at 4, 10.8% at 5, 17.3% at 6, 27% at 7 and around 41% at 8 or more. A complete score of 2 or less is regarded as low risk (rebleeding about 4%, mortality under 0.2%). Local figures differ, so use the risk band as the main output.
When can the pre-endoscopy score be used on its own?
The pre-endoscopy score helps identify, on admission, patients at higher risk who may need critical-care review before endoscopy, and very low scores that may support early discharge in the right setting. Many services pair it with the Glasgow-Blatchford score, which needs no endoscopy at all and is better at identifying patients who can avoid intervention. The original 1996 Rockall study found the score performed better at predicting mortality than at predicting rebleeding, a limitation later validation studies have also noted.
When should the Rockall score not be relied on?
The Rockall score estimates rebleeding and mortality risk after upper GI bleeding and is not a diagnosis or a management protocol. The complete score needs endoscopic findings, and the score performs less well for identifying the very lowest-risk patients than the Glasgow-Blatchford score. This is an educational reference, not medical advice.
This is a reference tool, not a diagnosis or medical advice. Results depend on the laboratory, assay and clinical context, and reference intervals vary between labs and by age and sex — always read your result against the range printed on your own report and discuss it with a qualified healthcare professional.
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