4706 The rockall score is a useful prognostic tool in gastroduodenal ulcer haemorrhage.

Background and aim. Gastroduodenal ulcer bleeding is the major cause of endoscopic examination on emergency. Patients with acute upper gastrointestinal haemorrhage (UGIH) are routinely hospitalized regardless of the clinical status or the stigmata of bleeding. The Rockall's score (1) was recently tested for its prognostic value after UGIH. The aim of the present study was to validate Rockall's score in a set of patients with gastroduodenal ulcer bleeding in an Italian teaching hospital and to prove his usefulness in improving quality of care. Material and methods. From May/96 to May/97 100 consecutive patients, admitted as emergencies for UGIH, underwent endoscopy within 6 hours of admission and were found affected by gastroduodenal ulcer (peptic or malignant). All the patients with active bleeding (42) and most of the ones with stigmata of recent haemorrhage were treated endoscopically by injection of 10-20 ml 1:10,000 adrenaline. Initial Rockall's score (iR - based on age and presence of shock and comorbidity) and total Rockall's score (tR - sum of iR and a score related to endoscopic findings) were calculated for each patient. Results. Initial haemostasis was achieved in all cases, but 19 patients recurred; 12 died, 9 after at least one rebleeding. Median iR and median tR were 2 (range 0-6) and 4 (1-9) for non-rebleeders vs. 3 (0-7) and 6 (3-10) for rebleeders ( p 8 rebled and died. The average length of hospital stay was 10.3 days for all patients and 4.4 for the group with tR