rope_risk_score: Risk of Paradoxical Embolism (RoPE) Score

In cliot: Clinical Indices and Outcomes Tools

Risk of Paradoxical Embolism (RoPE) Score

Description

Calculates the RoPE Score to estimate the probability that a cryptogenic stroke is related to a Patent Foramen Ovale (PFO). The score ranges from 0 to 10, with higher scores indicating a higher PFO-attributable fraction (i.e., it is more likely the PFO caused the stroke rather than being an incidental finding).

Usage

rope_risk_score(age, history_hypertension, history_diabetes,
                history_stroke_tia, current_smoker, cortical_infarct)

Arguments

age	Numeric. Patient age in years. 18-29: +5 pts 30-39: +4 pts 40-49: +3 pts 50-59: +2 pts 60-69: +1 pt >=70: 0 pts
history_hypertension	Numeric (0 or 1). History of hypertension. (0 = No [+1 pt], 1 = Yes [0 pts]).
history_diabetes	Numeric (0 or 1). History of diabetes. (0 = No [+1 pt], 1 = Yes [0 pts]).
history_stroke_tia	Numeric (0 or 1). History of prior stroke or TIA. (0 = No [+1 pt], 1 = Yes [0 pts]).
current_smoker	Numeric (0 or 1). Current smoker. (0 = No [+1 pt], 1 = Yes [0 pts]).
cortical_infarct	Numeric (0 or 1). Cortical infarct present on imaging. (1 = Yes [+1 pt], 0 = No [0 pts]).

Value

A list containing:

RoPE_Score	The calculated total score (Range 0-10).
PFO_Attributable_Fraction	The estimated probability that the stroke is PFO-related.
Stroke_Recurrence_Risk	General risk category for 2-year stroke recurrence.

References

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. doi:10.1212/WNL.0b013e3182a08d59

Examples

# Example 1: High Probability of PFO-related stroke
# 35yo, No HTN, No DM, No Prior Stroke, Non-smoker, Cortical Infarct
# Score: 4(age) + 1(HTN) + 1(DM) + 1(Hx) + 1(Smoke) + 1(Cortical) = 9
rope_risk_score(35, 0, 0, 0, 0, 1)

# Example 2: Low Probability (Incidental PFO likely)
# 65yo, HTN, Smoker, Prior Stroke
# Score: 1(age) + 0 + 1(DM) + 0 + 0 + 0(Subcortical) = 2
rope_risk_score(65, 1, 0, 1, 1, 0)

cliot documentation built on Dec. 1, 2025, 1:06 a.m.