Document Detail

Prospective validation of the Rockall risk scoring system for upper GI hemorrhage in subgroups of patients with varices and peptic ulcers.
MedLine Citation:
PMID:  11922558     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: The Rockall risk assessment score was devised to allow prediction of the risk of rebleeding and death in patients with upper GI hemorrhage. The score was derived by multivariate analysis in a cohort of patients with upper GI hemorrhage and subsequently validated in a second cohort. Only 4.4% of patients included in the initial study had esophageal varices, and analysis was not performed according to the etiology of the bleeding. Our aim was to assess the validity of the Rockall risk scoring system in predicting rebleeding and mortality in patients with esophageal varices or peptic ulcers. METHODS: Admissions (n = 358) over 32 months to a single specialist GI bleeding unit were scored prospectively. The distribution of episodes of rebleeding and mortality by Rockall score were statistically analyzed using Fisher's exact test with 99% CIs calculated using a Monte Carlo method. The Child-Pugh score was determined in patients with esophageal varices. RESULTS: The Rockall score was predictive of both rebleeding and mortality in patients with variceal hemorrhage (both ps < 0.0005), as was the Child-Pugh score (p = 0.001 and p < 0.0005, respectively). The initial Rockall score was predictive of mortality in patients with peptic ulcers (p = 0.01), although the complete score was not (p > 0.05). The complete score did, however, predict rebleeding in these patients (p = 0.001). CONCLUSION: This is the first study to validate the Rockall score in specific subgroups of patients with esophageal varices or peptic ulcers and suggests that it is particularly applicable to variceal hemorrhage.
D S Sanders; M J Carter; R J Goodchap; S S Cross; D C Gleeson; A J Lobo
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Publication Detail:
Type:  Journal Article; Validation Studies    
Journal Detail:
Title:  The American journal of gastroenterology     Volume:  97     ISSN:  0002-9270     ISO Abbreviation:  Am. J. Gastroenterol.     Publication Date:  2002 Mar 
Date Detail:
Created Date:  2002-03-29     Completed Date:  2002-04-19     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0421030     Medline TA:  Am J Gastroenterol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  630-5     Citation Subset:  IM    
Department of Histopathology, The Royal Hallamshire Hospital, Sheffield, United Kingdom.
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MeSH Terms
Aged, 80 and over
Cohort Studies
Esophageal and Gastric Varices / complications*,  mortality*
Gastrointestinal Hemorrhage / etiology*,  mortality*
Middle Aged
Outcome Assessment (Health Care)
Peptic Ulcer / complications*,  mortality*
Predictive Value of Tests
Prospective Studies
Reproducibility of Results
Risk Assessment

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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