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Kent DM, Saver JL, Kasner SE, et al. Evaluating Therapies to Prevent Future Stroke in Patients with Patent Foramen Ovale-Related Strokes — The SCOPE Study [Internet]. Washington (DC): Patient-Centered Outcomes Research Institute (PCORI); 2023 Apr. doi: 10.25302/04.2023.RS.SCOPE2019001
| RoPE score calculator a | ||
| Characteristic | Points | |
| No history of hypertension | 1 | |
| No history of diabetes | 1 | |
| No history of stroke or transient ischemic attack | 1 | |
| Nonsmoker | 1 | |
| Cortical infarct on imaging | 1 | |
| Age, y | ||
| 18-29 | 5 | |
| 30-39 | 4 | |
| 40-49 | 3 | |
| 50-59 | 2 | |
| 60-69 | 1 | |
| ≥70 | 0 | |
| Total RoPE score (sum of individual points) = ______ | ||
| PASCAL classification system b | ||
| High RoPE score (≥7) | High-risk PFO feature (LS and/or ASA)c | PFO-related stroke |
| Absent | Absent | Unlikely |
| Absent | Present | Possible |
| Present | Absent | |
| Present | Present | Probable |
Abbreviations: ASA, atrial septal aneurysm; LS, large shunt; PASCAL, PFO-Associated Stroke Causal Likelihood; PFO, patent foramen ovale; RoPE, Risk of Paradoxical Embolism.
aThe RoPE score assesses the probability that a PFO discovered in the setting of an otherwise-cryptogenic stroke was pathogenically related to the stroke rather than an incidental finding. The RoPE score ranges from 0 to 10, with scores of 0 to 3 indicating a negligible likelihood that the stroke is attributable to the PFO and a score of 10 indicating an approximately 90% probability that the stroke is attributable to the PFO.
bPASCAL combines the RoPE score with the presence or absence of high-risk PFO features to determine the likelihood that the PFO was causally related to the index stroke. See Appendix A2 for details on RoPE and Appendix A3 for details on PASCAL.
cASA is defined as ≥10 mm of excursion from midline. Large shunt size was defined in our database as >20 bubbles in the left atrium on transesophageal echocardiogram.
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