ToolsCalculators
Risk of Paradoxical Embolism (RoPE) Score
Risk of Paradoxical Embolism (RoPE) Score
Age
No history of hypertension
No history of diabetes
No history of prior stroke or TIA
Non-smoker
Cortical infarct on imaging
Result0 points
Approximate PFO-attributable fraction of stroke: 0 %.
- PFO-attributable fraction
- 0 %
When to use
- Estimating whether a discovered PFO is likely the stroke mechanism versus an incidental finding in cryptogenic stroke.
Formula
Age band (18-29=5 … ≥70=0) + 1 point each for no hypertension, no diabetes, no prior stroke/TIA, non-smoker, and cortical infarct on imaging. Range 0-10.
Pearls and pitfalls
- A low score with a PFO present suggests the PFO is likely incidental; a high score suggests it is likely causal.
- Should inform, not replace, individualized multidisciplinary discussion about PFO closure.
- The published attributable-fraction table is non-monotonic near the middle of the range (score 4 = 38% vs score 5 = 34%) due to small sample sizes at those score levels in the derivation cohort — this is a genuine feature of the original data, not a transcription error.