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Rockall Score (Pre-endoscopy / Clinical)

The pre-endoscopy (clinical) Rockall score (0–7) uses age, shock and comorbidity to estimate mortality in upper GI bleeding before endoscopy. A score of 0 identifies very low risk; it is completed after endoscopy as the full Rockall score.

  • Age (years)
  • Heart rate (/min)
  • Systolic blood pressure (mmHg or kPa)
  • Comorbidity: No major comorbidity (0); Cardiac failure, ischemic heart disease, or any major comorbidity (2); Renal failure, liver failure, or disseminated malignancy (3)
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Interpretation

ResultMeaning
0Very low risk
1–2Low–moderate
≥ 3Higher mortality risk

Formula

Age <60 = 0, 60–79 = 1, ≥80 = 2 · Shock: none (SBP ≥100, HR <100) = 0, tachycardia (HR ≥100, SBP ≥100) = 1, hypotension (SBP <100) = 2 · Comorbidity: none = 0, cardiac failure/IHD/any major = 2, renal failure/liver failure/disseminated malignancy = 3

Clinical pearls

  • Predicts mortality, not need for intervention; Glasgow-Blatchford is better for deciding outpatient care.
  • The 0.2% mortality for a score of 0 is from the 1996 UK derivation cohort.

Examples

pre-endoscopy rockall 72 yo hr 110 sbp 120 ihdclinical Rockall score for an 85 year old with BP 90 systolic, pulse 120, and liver failurerockall pre 45 hr 80 sbp 130 no comorbidities

FAQ

What is the difference between pre-endoscopy and full Rockall?

The pre-endoscopy score uses age, shock and comorbidity (max 7); the full score adds endoscopic diagnosis and stigmata of recent haemorrhage (max 11).

Evidence

  1. Rockall TA et al. Risk assessment after acute upper gastrointestinal haemorrhage. Gut 1996;38:316–21.

Hepatology & GI · Reviewed 2026-10-14 · Methodology