Identify patients at risk of adverse outcome following acute upper gastrointestinal bleeding.
The scoring system uses clinical criteria (increasing age, co-morbidity, shock) as well as endoscopic finding (diagnosis, stigmata of acute bleeding).
A convenient memnoic is ABCDE - i.e. Age, Blood pressure fall (shock), Co-morbidity, Diagnosis and Evidence of bleeding.
The utility of a modified Rockall score (that is, a score lacking endoscopic findings) has not been established.
The definition of mild, moderate, or severe risk remains a matter of clinical judgement.
According to SIGN guidleines, only patients with Rokall score of 0 can be savely managed as outpatient.
The predicted mortality:
Score 0 0.2%
Score 1 2.4%
Score 2 5.6%
Score 7 50%
The scoring system uses clinical criteria (increasing age, co-morbidity, shock) as well as endoscopic finding (diagnosis, stigmata of acute bleeding).
A convenient memnoic is ABCDE - i.e. Age, Blood pressure fall (shock), Co-morbidity, Diagnosis and Evidence of bleeding.
The utility of a modified Rockall score (that is, a score lacking endoscopic findings) has not been established.
The definition of mild, moderate, or severe risk remains a matter of clinical judgement.
According to SIGN guidleines, only patients with Rokall score of 0 can be savely managed as outpatient.
The predicted mortality:
Score 0 0.2%
Score 1 2.4%
Score 2 5.6%
Score 7 50%
Which of the following is not an element of the Rockall score?
ReplyDeletea) Pulse
b) Comorbidities
c) Alcohol history
d) Age
e) Blood pressure
a 61 years old male presented with coffee ground vomiting. on admission to the ward, he was haemodynamically stable with HR 90 bpm and BP of 110/75. he has a past medical history of renal failure and was previously on dialysis. Apart from gastritis, his OGD was normal.
ReplyDeleteWhat is the Rokall score?, what is the predicted mortality?
A 76-year-old woman was admitted with haematemesis and melaena. She was taking ibuprofen for osteoarthritis, but had no history of dyspepsia. There was a history of hypertension, severe chronic obstructive pulmonary disease and stroke.
ReplyDeleteOn examination, she was comfortable, but rather pale and sweaty. Her pulse was 104 beats per minute and her blood pressure was 108/75 mmHg. Abdominal examination was normal.
Investigations:
haemoglobin 85 g/L (115–165)
serum urea 15.4 mmol/L (2.5–7.0)
serum creatinine 106 µmol/L (60–110)
What is her pre-endoscopy Rockall risk score for severity of upper gastrointestinal haemorrhage?
A: 3
B: 4
C: 5
D: 6
E: 7
The patient scores 1 for her age; 1 for tachycardia; and 2 for ‘any major co-morbidity’ (ie severe chronic obstructive pulmonary disease).
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