The Initial Rockall score is designed to estimate the risk of mortality due to upper gastrointestinal bleeding by evaluating three factors: age, the presence and degree of shock, and any major comorbidities. Each factor is assigned a score, and these scores are then summed to provide an overall risk score.

For age, the scoring is:
- Less than 60 years: 0 points
- Between 60 and 79 years: 1 point
- 80 years or older: 2 points

Shock is assessed based on blood pressure and heart rate:
- No shock, with systolic blood pressure (SBP) of at least 100 mmHg and heart rate (HR) less than 100 bpm: 0 points
- SBP of at least 100 mmHg with HR of at least 100 bpm: 1 point
- SBP less than 100 mmHg: 2 points

Comorbidities are scored as follows:
- No major comorbidity: 0 points
- Any major comorbidity, such as cardiac failure or ischemic heart disease: 2 points
- Renal failure, liver failure, or disseminated malignancy: 3 points

The total Rockall score is the sum of these individual scores, ranging from 0 to 7 points. This score is then translated into an interpretation of mortality risk:

- A score of 0 indicates a risk of mortality of 0.2%.
- A score of 1 corresponds to a risk of 2.4%.
- A score of 2 corresponds to a risk of 5.6%.
- A score of 3 corresponds to a risk of 11%.
- A score of 4 corresponds to a risk of 24.6%.
- A score of 5 corresponds to a risk of 39.6%.
- A score of 6 corresponds to a risk of 48.9%.
- A score of 7 corresponds to a risk of 50%.

By examining these factors systematically and assigning the appropriate numerical scores, healthcare providers can gain a clearer understanding of the patient’s mortality risk due to upper gastrointestinal bleeding, facilitating more informed clinical decisions.

The Initial Rockall Score is a clinical calculator used for predicting mortality due to upper gastrointestinal (GI) bleeding. This scoring system is applicable to patients who present with upper GI bleeding, regardless of the underlying cause. The score is calculated based on three parameters: age, shock, and presence of comorbidity. The higher the score, the higher the risk of mortality. 

The clinical utility of the Initial Rockall Score is to aid in risk stratification of patients with upper GI bleeding, helping clinicians to identify high-risk patients who may require more aggressive management or intervention. It can also assist in decision-making regarding hospital admission and discharge.

There are no specific exclusion criteria for the use of the Initial Rockall Score. However, it should be noted that this score does not take into account the severity or source of the bleeding, and therefore should be used in conjunction with other clinical findings and diagnostic tools.

Rockall score for upper GI bleeding