Risk of Paradoxical Embolism Score
Used in the assessment of patients with cryptogenic stroke who are found to have a PFO. Estimates the likelihood that the stroke was due to the PFO.
Score Calculation
| Characteristic | Points |
|---|---|
| Age: | |
| 18 - 29 | +5 |
| 30 - 39 | +4 |
| 40 - 49 | +3 |
| 50 - 59 | +2 |
| 60 - 69 | +1 |
| ≥ 70 | 0 |
| No hypertension | +1 |
| No diabetes | +1 |
| Non-smoker | +1 |
| No prior stroke/TIA | +1 |
| Cortical infarct on imaging | +1 |
Score Interpretation
| Score | Likelihood of PFO as Cause | 2 Year Stroke/TIA Risk |
|---|---|---|
| % (95% CI) | % (95% CI) | |
| 0 - 3 | 0% (0 - 4) | 20% (12 - 28) |
| 4 | 38% (25 - 48) | 12% (6 - 18) |
| 5 | 34% (21 - 45) | 7% (3 - 11) |
| 6 | 62% (54 - 68) | 8% (4 - 12) |
| 7 | 72% (66 - 76) | 6% (2 - 10) |
| 8 | 84% (79 - 87) | 6% (2 - 10) |
| 9 - 10 | 88% (83 - 91) | 2% (0 - 4) |
Although the RoPE score is not designed for guiding PFO closure, there is some evidence that patients with RoPE score > 7 are more likely to derive benefit than those with RoPE score ≤ 7.