The Rockall scoring system was developed in unselected patients, the majority of whom did not receive endoscopic therapy.
Dr Nicholas Church and colleagues from England assessed the validity of the Rockall system in high-risk patients undergoing endoscopy for peptic ulcer hemorrhage.
The team calculated Rockall scores in 247 patients with major peptic ulcer bleeding entered into a randomized trial of endoscopic therapy.
The observed rates of recurrent bleeding and mortality after endoscopic therapy were compared with predicted rates derived from Rockall's study group.
The research team assessed the validity of the Rockall system in terms of calibration and discrimination.
|Mortality rates after endoscopic therapy increased with an increasing Rockall score|
The researchers discovered that the rates of recurrent bleeding and mortality after endoscopic therapy increased with an increasing Rockall score.
The observed rates of recurrent bleeding and mortality were below predicted rates.
The team noted that calibration of the Rockall system was poor.
For the prediction of recurrent bleeding, the area under the receiver operating characteristic curve was low at 63%.
The researchers found that the system was satisfactory when predicting mortality.
Dr Church's team concluded, “After endoscopic therapy for a bleeding peptic ulcer, the Rockall scoring system can identify patients at high risk of death.”
“It is inadequate for the prediction of recurrent bleeding.”