Rockall Score

Predicts mortality and risk of rebleeding after upper gastrointestinal bleeding.

Gastroenterology GastroenterologyEvidence-BasedUpdated 2026-07

Clinical Notes

Formula

Composite score using Age, Shock, Comorbidity, Diagnosis and Endoscopic Stigmata.

Clinical Notes

Higher Rockall Scores are associated with increased mortality and recurrent bleeding.

References

Rockall TA et al. Gut. 1996.
ESGE Guideline.
NICE Upper GI Bleeding Guideline.

Calculator Information

Specialty

Gastroenterology

📋 Reference Ranges

Reference ranges for this calculator
Classification	Range
Low Risk	0–2
Moderate Risk	3–4
High Risk	≥5

What This Calculator Measures

Calculates the Rockall score to predict mortality and the risk of rebleeding after acute upper gastrointestinal bleeding using clinical and endoscopic findings.

How to Use

Select the age band, shock category, comorbidity, endoscopic diagnosis, and major stigmata of recent hemorrhage.
The full Rockall score requires endoscopic findings, so complete it after endoscopy.
Interpret the total score against the 0–2, 3–4, and ≥5 bands.

Interpretation Guide

Rockall 0–2 indicates low risk of mortality and rebleeding; 3–4 moderate risk with close monitoring; ≥5 high risk of mortality and recurrent bleeding requiring urgent specialist management.

Age-specific interpretation

Clinical Significance

The Rockall score is a well-validated tool for predicting mortality after upper GI bleeding and complements pre-endoscopy scores such as the Glasgow-Blatchford score.

When to Use

Post-endoscopy risk stratification in upper GI bleeding
Estimating mortality in hospitalized patients with UGIB
Guiding the intensity of monitoring and follow-up endoscopy

When Not to Use

Pre-endoscopy triage in the emergency department, where scores such as the Glasgow-Blatchford are used
Isolated lower GI bleeding
Children

Limitations

The full score requires endoscopic findings and cannot be completed before endoscopy.
Comorbidity weighting is coarse and may under-represent complex illness.
It predicts mortality/rebleeding but was not designed to decide pre-endoscopy admission.

Worked Example

An 82-year-old man presents with hematemesis. He is tachycardic but not hypotensive. Endoscopy shows a non-bleeding ulcer without major stigmata.

Inputs:

age: 2

shock: 1

comorbidity: 0

diagnosis: 1

stigmata: 0

Rockall score = 2 + 1 + 0 + 1 + 0 = 4 — moderate risk of mortality and rebleeding; close monitoring is recommended.

Evidence

Source: Gastroenterology / Emergency Medicine
Reference: Rockall TA, et al. Gut. 1996;38(3):316-321.
Reviewed By: MedCalcHub Clinical Team
Version: 1996
Updated: 2026-08

Rockall TA, et al. Gut. 1996;38(3):316-321.

References

Rockall TA, et al. Risk assessment after acute upper gastrointestinal haemorrhage. Gut. 1996;38:316-321. (Original score)

Disclaimer: This calculator is intended for educational and clinical decision support. Risk scores inform but do not replace clinical judgment in the management of upper GI bleeding.