Update on risk scoring systems for patients with upper gastrointestinal haemorrhage

Table 1 Rockall score

Component score	0	1	2	3
Age (yr)	< 60	60-79	≥ 80	-
Haemodynamics:
Pulse (bpm)	< 100	≥ 100	-	-
Systolic BP (mmHg)	≥ 100	≥ 100	< 100	-
Comorbidities	None	-	IHD, cardiac failure, other major comorbidity	Renal or liver failure, disseminated malignancy
Diagnosis	MW or no lesion and no stigmata	All other diagnosis	Malignant lesions of UGIT	-
Stigmata of haemorrhage	No stigmata or dark spot on ulcer	-	Blood in UGIT, adherent clot, visible/spurting vessel	-

A score of ≤ 2 identifies a low-risk patient suitable for early discharge. UGIT: Upper gastrointestinal tract; IHD: Ischaemic heart disease; MW: M-Weiss tear; GI: Gastrointestinal. BP: Blood pressure.

Table 2 Glasgow blatchford score

Admission risk marker	Score
Blood urea (mmol/L)
6.5-8	2
8-10	3
10-25	4
> 25	6
Hb (g/L)
Men
120-130	1
100-120	3
< 100	6
Women
100-120	1
< 100	6
Systolic BP (mmHg)
100-109	1
90-99	2
< 90	3
Pulse ≥ 100/min	1
History and comorbidities
Melaena	1
Syncope	2
Hepatic disease1	2
Cardiac failure2	2

¹History of or clinical/laboratory evidence of liver disease;

²History of or clinical/echocardiographic evidence of cardiac failure. A score of zero identifies low-risk patients suitable for non-admission; BP: Blood pressure.

Table 3 Summary of major published risk scores for upper gastrointestinal haemorrhage

Score[Ref.]	Endoscopy required?	Number of variables	Suitable for unselected upper GI bleeding patients?
Full Rockall[5]	Yes	61	Yes
Baylor[6]	Yes	5	No
Cedars Sinai[7]	Yes	6	Yes
Admission Rockall[5]	No	41	Yes
Glasgow Blatchford[18]	No	52	Yes
ANN[21]	No	20	No

¹Comorbidities variable describes 5 specific conditions;

² History and comorbidities variable describes 4 specific situations. GI: Gastrointestinal; ANN: Artificial neural network.