Hematemesis is the medical term for vomiting blood. The blood may appear bright red or look like dark coffee grounds. This usually indicates bleeding in the upper digestive tract, which includes the esophagus, stomach, or the first part of the small intestine.
Common causes of hematemesis include:
Hematemesis can be a sign of a serious medical condition and should be evaluated by a healthcare professional right away. The amount and cause of bleeding help guide treatment decisions.
The Rockall Score is a clinical tool used to estimate the risk of complications or death in patients with upper gastrointestinal bleeding, such as hematemesis. It helps doctors determine how serious the bleeding is and what kind of care is needed.
The score is based on two main parts:
The Rockall Score helps evaluate the seriousness of upper gastrointestinal bleeding, such as vomiting blood (hematemesis). By combining different health factors, it gives an overall risk score that can guide decisions about care and monitoring.
This score is especially helpful in identifying patients who may need urgent treatment, hospital admission, or further medical tests. It can also help reassure low-risk patients and reduce unnecessary interventions.
Bleeding from the digestive tract can stop and start again. Calculating the risk of recurrence helps predict whether the bleeding might come back. This is important because:
Knowing your risk score empowers both patients and healthcare providers to take the right steps for safety and recovery.
This calculator is designed for use by:
The Rockall Score starts with an assessment of the patient’s condition before an endoscopy is performed. These pre-endoscopic criteria help estimate risk early on, even before the exact source of bleeding is found.
They include three key factors: age, presence of shock, and other existing health conditions (co-morbidities). Each factor is scored and contributes to the overall risk level.
Age is an important factor because older patients often face higher risks with gastrointestinal bleeding. The Rockall Score divides age into three categories:
As age increases, the score rises, reflecting the increased likelihood of complications.
Shock is a serious condition that can occur when the body loses a lot of blood. It’s assessed by measuring heart rate and blood pressure:
Higher scores indicate more severe signs of shock and a higher risk of complications.
Co-morbidities refer to other health conditions a patient may already have. These can make recovery more difficult. The scoring is as follows:
These conditions increase the overall risk and may affect the choice of treatment and level of monitoring.
After an endoscopy is performed, additional details become available that help refine the Rockall Score. These post-endoscopic criteria include the cause of bleeding (diagnosis) and whether there are visible signs of active bleeding during the procedure.
These findings are critical for understanding the severity of the condition and the chances of the bleeding recurring.
The diagnosis made during endoscopy plays a key role in risk scoring. Different causes of bleeding carry different levels of risk:
Serious diagnoses, like cancer, increase the score due to the higher risk of ongoing or recurring bleeding.
During the endoscopy, doctors also look for signs that bleeding is currently active or likely to recur. These include:
Visible signs of bleeding during the procedure suggest a higher risk and lead to a higher Rockall Score, helping guide urgent treatment decisions.
This calculator helps estimate your risk based on the Rockall Score. Follow these simple steps to complete the form and get your results:
Use the scores to understand your risk level and discuss the results with a healthcare provider if needed.
For each section of the calculator, choose the answer that best matches your situation or the patient’s condition. Only one option should be selected per category.
Here’s how to select properly:
After clicking the “Calculate” button, you will see two scores:
Higher scores indicate a higher risk of serious complications or recurrence of bleeding. Use these scores to discuss your next steps with a healthcare provider and determine the best course of treatment or follow-up care.
The Rockall Score helps estimate your risk of complications or recurrence of bleeding. Once you’ve calculated your Pre-endoscopic and Post-endoscopic scores, you can use them to understand your risk level.
In general, a lower score means a lower risk, while a higher score suggests a need for closer monitoring or medical intervention. Below is a simple guide to interpret your results.
Score: 0–2
What to do: Follow up with your doctor, take prescribed medications, and watch for any new symptoms. Regular monitoring may be sufficient.
Score: 3–5
What to do: Stay in close contact with your healthcare provider. You may need additional tests, medication, or short-term hospital care.
Score: 6 or higher
What to do: Seek immediate medical care. This score usually requires close supervision, potential interventions, and follow-up with specialists.
Once you’ve calculated your Rockall Score, the next step is to take action based on your risk level. Whether your score is low, medium, or high, it’s important to understand what it means and how to respond.
This score is not a diagnosis, but it helps guide decisions about further care, observation, or urgent treatment.
Regardless of your score, you should seek immediate medical help if you experience any of the following:
The Rockall Score is used to estimate the risk of complications or death in patients who have upper gastrointestinal bleeding, such as vomiting blood (hematemesis). It helps doctors decide how serious the bleeding is and what type of care is needed.
You can use the calculator to get an idea of your risk level, but it is not a replacement for medical advice. Always consult a healthcare professional for diagnosis and treatment, especially if you are experiencing symptoms of bleeding.
The pre-endoscopic score is based on basic health information before any procedure, like age, shock status, and co-existing health problems. The post-endoscopic score adds findings from an endoscopy to give a more complete risk assessment.
If your score is 6 or higher, you may be at high risk for complications. Seek medical attention immediately. A doctor may recommend further testing, hospitalization, or urgent treatment based on your condition.
Yes. If your health condition changes, especially after an endoscopy or treatment, your score may also change. It’s important to reassess if new symptoms appear or if your medical condition worsens.
While it’s designed for use by healthcare providers, informed patients and caregivers can also use it to better understand risk levels. However, results should always be discussed with a medical professional.
No score guarantees complete safety. Even with a low score, you should monitor your symptoms and follow your doctor's advice. Bleeding can return, and your condition can change over time.
Here are simple explanations for some of the medical terms used in the Rockall Score Calculator: