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Home/Clinical calculators/Rockall Score

Clinical calculator · Gastroenterology and hepatology

Rockall Score

Predicts rebleeding and mortality risk after upper GI bleeding based on pre- and post-endoscopy factors

Highest activation tier
Recommended
How it is scored
Scored in code; a detected disagreeing draft value is flagged for correction
Care settings
Emergency department, Inpatient

When it activates

Scribeable activates a calculator from the encounter. The Rockall Score can activate when the transcript or pasted chart context documents any of these:

  • Post-endoscopy GI bleed risk assessment
  • Upper GI bleed prognosis
  • Rebleeding risk estimation
  • GI bleed disposition after endoscopy

A coded diagnosis can also activate it. ICD-10 prefixes carried by the registry: K92.

  • GI Bleed K92.0

Note-type scope: it activates on notes whose subject resolves to hepatology, gi, hospital medicine, critical care. A note that resolves to another subject does not carry it even when the clinician's specialty matches; a note with no resolvable subject (a generic consultation) falls back to the specialty match.

Inputs the note needs

5 inputs. Each is resolved from the transcript, the pasted chart context and charted labs; at this calculator’s tier a missing input is never requested, and a missing required input keeps the score out of the draft.

InputTypeUnit / optionsGuidance
Patient ageage
Shock: none, tachycardia (HR>100), or hypotension (SBP<100)vital
Comorbidity: none, major (CHF, IHD, major comorbidity), or renal/liver failure/metastatic cancerhistory
Endoscopic diagnosis: Mallory-Weiss/no lesion, all other, or malignancyexam
Major stigmata of hemorrhage: none, blood/adherent clot/visible vessel/spurtingexam

Reference for licensed clinicians. Where the registry text carries dose thresholds or conversion factors, they are as published in the cited sources. This page is not a prescribing tool and not individualised medical advice; verify against a current drug reference and the current guideline before acting. Medical disclaimer.

Scoring

Age: <60=0, 60-79=1, ≥80=2. Shock: none=0, tachycardia=1, hypotension=2. Comorbidity: none=0, major=2, renal/liver/mets=3. Diagnosis: MW/no lesion=0, other=1, malignancy=2. Stigmata: none=0, blood/clot/vessel/spurting=2. Max 11.

Formula as the note renders it

Age Patient age + Shock Shock: none, tachycardia (HR>100), or hypotension (SBP<100) + Comorbidity Comorbidity: none, major (CHF, IHD, major comorbidity), or renal/liver failure/metastatic cancer + Diagnosis Endoscopic diagnosis: Mallory-Weiss/no lesion, all other, or malignancy + Stigmata Major stigmata of hemorrhage: none, blood/adherent clot/visible vessel/spurting

Interpretation

≤2: Low risk (~5% rebleed, <1% mortality). 3-5: Moderate risk (~11% rebleed, 6% mortality). >5: High risk (~25% rebleed, 17% mortality).

Evidence

Sources carried in Scribeable's citation registry for this calculator; guideline version: Rockall TA et al. 1996.

  • Rockall TA et al. Risk assessment after acute upper gastrointestinal haemorrhage (Rockall Score)Rockall et al. 1996 · 1996 · Level I · link last verified 2026-03-28

How Scribeable handles it in the note

When an encounter activates the Rockall Score (its highest tier is recommended), Scribeable does not ask you for missing inputs. The score is computed in code from whatever inputs resolve from the transcript, the pasted chart context or charted labs; a computed value is written into the draft only when every required input already resolves.

The score is computed in code from the resolved inputs, not recalled by the language model. If the draft states a Rockall Score value that disagrees with the computed one, the disagreement is flagged to the second drafting pass, which is instructed to correct the score and its interpretation before you see the note.

Classified as a risk score: activated strictly, by a documented trigger, never by a permissive reading of the encounter.

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Can activate in: Internal Medicine, Emergency Medicine, Gastroenterology, Hospital Medicine, Critical Care / ICU.

Scored in code

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