RoPE Score Calculator (Paradoxical Embolism)

Risk of Paradoxical Embolism (RoPE) score for PFO-attributable cryptogenic stroke (0–10).

For educational and clinical reference. Not a substitute for medical judgment. See the medical disclaimer.
Score
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Interpretation
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References

  1. Kent DM, Ruthazer R, Weimar C, et al. An index to identify stroke-related vs incidental patent foramen ovale in cryptogenic stroke. Neurology. 2013;81(7):619-625.

How to use

  1. Select each vascular risk factor (absence scores a point), cortical infarct, and age band.
  2. The total RoPE score (0–10) and PFO-attributable fraction update instantly.
  3. Use to inform causal attribution and PFO-closure discussions in cryptogenic stroke.

Frequently asked questions

What is the RoPE score?

The Risk of Paradoxical Embolism score estimates the probability that a patent foramen ovale (PFO) found in a cryptogenic-stroke patient is causally related to the stroke.

How is the RoPE score interpreted?

Higher scores (younger patients with few vascular risk factors and a cortical infarct) indicate a higher PFO-attributable fraction, supporting that the PFO is pathogenic.

Does a high RoPE score mean PFO closure is indicated?

It supports a causal role and identifies patients more likely to benefit, but closure decisions also use anatomic features (shunt size, atrial septal aneurysm) and shared decision-making.

Why do risk factors lower the score?

Conventional vascular risk factors make a competing stroke mechanism more likely, reducing the probability that the PFO is the cause.

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