Rockall Score

Background Information

What is HemoPill® acute?

The HemoPill® acute is a swallowable sensor capsule for the immediate detection and exclusion of acute bleeding in the esophagus, stomach and small intestine. The HemoPill® acute has a measuring gap with an optical sensor.

Blood is detected in the measuring gap by analyzing the absorption of light at different wavelengths. The detection of blood is also possible in an unprepared digestive tract. The measured values generated by the HemoPill® acute are transmitted wirelessly in real time to the HemoPill® Receiver.

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The hypothesis for using the HemoPill® acute result as input for calculating the Complete Rockall score is based on the HemoPill® acute’s ability to detect the presence of blood or hematin in the GI tract. This ability has been confirmed by multiple studies.

In this scenario, a negative HemoPill® acute result is assumed to correspond to the following parameters of the Complete Rockall Score:
  • Diagnosis: No lesion and no stigmata of recent hemorrhage
  • Major stigmata of recent hemorrhage: None / Dark spots only
A positive HemoPill® acute result is assumed to correspond to:
  • Diagnosis: All other diagnoses
  • Major stigmata of recent hemorrhage: Blood in the upper GI tract / Adherent clot / Visible or spurting vessel
The HemoPill® acute does not allow to determine whether a positive reading is due to the presence of a Mallory-Weiss tear or malignancy specifically.

Pre-endoscopic Rockall Score

The pre-endoscopic Rockall Score estimates mortality in patients with active upper GI bleeding who have not undergone endoscopy. It is supported by multiple validation studies, most of which show moderate prediction of death at higher risk levels. It can predict very low risk patients, but with less accuracy. The pre-endoscopic Rockall score is calculated based on clinical signs (i.e., without incorporating endoscopy results).
Mortality rates, by pre-endoscopy score
Score Chance of mortality [%]
0 0.2%
1 2.4%
2 5.6%
3 11%
4 24.6%
5 39.6%
6 48.9%
7 50%

Complete Rockall score

The Complete Rockall Score is a score used to evaluate the risk of mortality and the likelihood of rebleeding in cases of gastrointestinal bleeding. The score is calculated based on the parameters of age, shock, comorbidity, diagnosis, and endoscopic findings.

The respective options that can be selected for these parameters are weighted differently, resulting in varying points that are summed up to a final score at the end. The score can range from 0 to 11 points. The higher the score, the higher the mortality risk and the probability of rebleeding.
Complete Rockall score with rebleeding and mortality rate
Score Rebleeding [%] Deaths (total) [%]
0 4.9 0
1 3.4 0
2 5.3 0.2
3 11.2 2.9
4 14.1 5.3
5 24.1 10.8
6 32.9 17.3
7 43.8 27
≥8 41.8 41.1
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