Decision Rule - Rockall Score for Upper Gastrointestinal (GI) Bleeding

Rockall Score for Upper Gastrointestinal (GI) Bleeding

This score is for use in patients who have not undergone endoscopy.

-Age . . . . . . . . . . . . . . . . . . . .  [<60 +0; 60-79 +1; =80 +2]

-Shock . . . . . . . . . . . . . . . . . . .  [No shock (SBP ≥100, HR <100) +0; Tachycardia (SBP ≥100, HR ≥100) +1; Hypotension (SBP <100) +2]

-Comorbidities . . . . . . . . . . . . . . .  [No major comorbidity +0; Any comorbidity EXCEPT renal failure, liver failure, and/or disseminated malignancy +2; Renal failure, liver failure, and/or disseminated malignancy +3]

[0 points]Patient is deemed to have a 0.2% mortality prior to endoscopy.

[1 point]Patient is deemed to have a 2.4% mortality prior to endoscopy.

[2 points]Patient is deemed to have a 5.6% mortality prior to endoscopy.

[3 points]Patient is deemed to have an 11% mortality prior to endoscopy.

[4 points]Patient is deemed to have a 24.6% mortality prior to endoscopy.

[5 points]Patient is deemed to have a 39.6% mortality prior to endoscopy.

[6 points]Patient is deemed to have a 48.9% mortality prior to endoscopy.

[7 points]Patient is deemed to have a 50% mortality prior to endoscopy.

https://www.mdcalc.com/rockall-score-upper-gi-bleeding-complete

Decision Rule - Glasgow-Blatchford Bleeding Score (GBS) for Upper Gastrointestinal (GI) Bleeding

Glasgow-Blatchford Bleeding Score (GBS) for Upper Gastrointestinal (GI) Bleeding

-Hemoglobin . . . . . . . . . . . . . . .  [>13 g/dL +0; 12-13 g/dL +1; 10-12 g/dL +3; <10 g/dL +6]

-BUN  . . . . . . . . . . . . . . . . . .  [<18.2 mg/dL +0; 18.2-22.3 mg/dL +2; 22.4-28 mg/dL +3; 28-70 mg/dL +4; >70 mg/dL +6]

-Initial systolic BP  . . . . . . . . . .  [≥110 mmHg +0; 100-109 mmHg +1; 90-99 mmHg +2; <90 mmHg +3]

-Heart rate ≥100 bpm  . . . . . . . . . .  [No +0; Yes +1]

-Melena present . . . . . . . . . . . . .  [No +0; Yes +1]

-Recent syncope . . . . . . . . . . . . .  [No +0; Yes +2]

-Hepatic disease history  . . . . . . . .  [No +0; Yes +2]

-Cardiac failure present  . . . . . . . .  [No +0; Yes +2]

[0 points]Patient is considered to be a "low risk" gastrointestinal bleed with a low likelihood of requiring intervention (blood transfusion, endoscopy, or surgery), and low risk for mortality in the next 6 months.

[1 point]Patient is considered to be a "low risk" gastrointestinal bleed with a low likelihood of requiring intervention (blood transfusion, endoscopy, or surgery), and low risk for mortality in the next 6 months.  Patient discussed with [Internal Medicine/Gastroenterology] who agreed with  plan for outpatient management.

[≥1 point]Patient is considered to be a "high risk" gastrointestinal bleed that is likely to require intervention (blood transfusion, endoscopy, or surgery).

According to the American College of Gastroenterology’s management guidelines for patients with overt upper GI bleeding, no risk scores can reliably predict which individual patients will need an intervention, except for patients with a Glasgow-Blatchford Score of 0 (< 1% chance of requiring intervention).

https://www.mdcalc.com/glasgow-blatchford-bleeding-score-gbs