What risk-scoring systems are used in upper GI bleeding?

The Rockall score (clinical and endoscopic findings) predicts rebleeding and death and can identify low-risk patients for early discharge. The Glasgow-Blatchford score uses urea, haemoglobin, and clinical markers (not endoscopy) to predict the need for intervention.

Clinical relevance. Risk scoring identifies low-risk patients for early discharge and high-risk patients needing urgent intervention.

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Risk scoring in upper GI bleeding

Scoring systems stratify risk, guide timing of endoscopy, and identify patients safe for early discharge.

Rockall score

• Based on clinical features and endoscopic findings (age, shock, comorbidity, diagnosis, stigmata of recent haemorrhage).
• Predicts rebleeding and death.
• A pre-endoscopy Rockall of 0-1 can identify patients for safe early discharge/outpatient endoscopy.

Glasgow-Blatchford score

• Uses plasma urea, haemoglobin, and clinical markers (blood pressure, pulse, melaena, syncope, liver/cardiac disease) - no endoscopic findings.
• Predicts the need for intervention (transfusion or endoscopic therapy); a low score may allow outpatient management.