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Neurology · Cardiology

PASCAL Classification calculator

Enter the published formula inputs below to calculate and interpret this score.

Clinical inputs

years

Allowed range: 18–120 years

Quick picks

Age points are 5 for 18–29, 4 for 30–39, 3 for 40–49, 2 for 50–59, 1 for age 60 through 70, and 0 only when age is greater than 70. Under 18 is not scored.

History of hypertension
History of diabetes
Prior stroke or transient ischemic attack
Current smoking

A nonsmoker scores 1 on the RoPE age-independent items. A current smoker scores 0.

Cortical infarct on imaging
High-risk PFO feature

A large shunt, an atrial septal aneurysm, or both. Either feature is enough.

Result

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Clinical inputs

  • Age (years)Accepted range: 18 to 120
  • History of hypertension
  • History of diabetes
  • Prior stroke or transient ischemic attack
  • Current smoking
  • Cortical infarct on imaging
  • High-risk PFO feature

Primary source

Kent DM et al. Heterogeneity of treatment effects in an analysis of pooled individual patient data from randomized trials of device closure of patent foramen ovale after stroke. JAMA. DOI: 10.1001/jama.2021.20956. PMID: 34905030. Table 1 scores RoPE as 1 point each for no hypertension, no diabetes, no prior stroke or TIA, nonsmoker, and a cortical infarct, plus age points 5 (18–29), 4 (30–39), 3 (40–49), 2 (50–59), 1 for age 60 through 70, and 0 only when age is greater than 70. PASCAL is probable when RoPE is at least 7 and a high-risk PFO feature is present (large shunt, atrial septal aneurysm, or both), possible when only one of those is present, and unlikely when neither is present. Reported here as 2, 1, and 0. (2021)

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