Interpretation
| Result | Meaning |
|---|---|
| 0–3 | PFO-attributable fraction 0%; 2-y recurrence 20% |
| 4 | 38%; 12% |
| 5 | 34%; 7% |
| 6 | 62%; 8% |
| 7 | 72%; 6% |
| 8 | 84%; 6% |
| 9–10 | 88%; 2% |
Formula
1 point each for: no hypertension, no diabetes, no prior stroke/TIA, non-smoker, cortical infarct on imaging. Age 18–29 5 · 30–39 4 · 40–49 3 · 50–59 2 · 60–69 1 · ≥70 0. Total 0–10.
Clinical pearls
- Use only in cryptogenic stroke with a PFO; the attributable fraction is a population estimate, not proof of causation in an individual.
- Closure trials enrolled mainly patients ≤60 years; the PASCAL classification combines RoPE with high-risk PFO features (atrial septal aneurysm, large shunt).
Examples
rope score 35 yo nonsmoker no htn no dm cortical infarctrisk of paradoxical embolism for a 52 year old smoker with hypertension, no diabetes, no prior stroke, subcortical infarctis the pfo causal 28F no risk factors cortical stroke
FAQ
What RoPE score suggests the PFO caused the stroke?
Scores of 7 or more correspond to PFO-attributable fractions of 72–88%; scores of 0–3 suggest the PFO is likely incidental.
Does a high RoPE score mean high recurrence risk?
No. Higher RoPE scores have lower 2-year recurrence (2% at 9–10 versus 20% at 0–3) because these patients have fewer conventional risk factors.