title: Predicting outcome of acute non-variceal upper gastrointestinal haemorrhage without endoscopy using the clinical Rockall Score.
abstract: BACKGROUND
  The Rockall risk scoring system uses clinical criteria and endoscopy to identify patients at risk of adverse outcomes after acute upper gastrointestinal haemorrhage. A clinical Rockall score obtained using only the clinical criteria may be able to predict outcome without endoscopy.
  
  
  OBJECTIVE
  To validate the clinical Rockall Score in predicting outcome after acute non-variceal upper gastrointestinal haemorrhage.
  
  
  METHODS
  A retrospective observational study of consecutive patients who were admitted with non-variceal acute upper gastrointestinal haemorrhage was undertaken. Medical records were abstracted using a standardised form.
  
  
  RESULTS
  102 cases were identified (51 men and 51 women; mean age 59 years). 38 (37%) patients considered to be at low risk of adverse outcomes (clinical Rockall Score 0) had no adverse outcomes and did not require transfusion. Patients with a clinical Rockall Score of 1-3 had no adverse outcomes, although 13 of 45 (29%) patients required blood transfusions. Clinical Rockall Scores >3 (n = 19) were associated with adverse outcomes (rebleeding in 4 (21%), surgery in 1 (5%) and death in 2 (10%)).
  
  
  CONCLUSIONS
  The clinical Rockall Score without endoscopy may be a useful prognostic indicator in this cohort of patients with acute non-variceal upper gastrointestinal haemorrhage. This score may reduce the need for urgent endoscopy in low-risk patients, which can instead be carried out on a more elective outpatient basis.
authors.affiliation: Division of Gastroenterology, Ulster Hospital, Dundonald, Belfast BT16 1RH, UK. ttham@utvinternet.com
authors.forename: T C K
authors.initials: TC
authors.lastname: Tham
authors.forename: C
authors.initials: C
authors.lastname: James
authors.forename: M
authors.initials: M
authors.lastname: Kelly
mesh_terms: D000208:Acute Disease; D016099:Endoscopy, Gastrointestinal; D004932:Esophageal and Gastric Varices / Q000628:therapy*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment / Q000592:standards; D012720:Severity of Illness Index