改良反常栓塞风险评分与缺血性卒中患者的卵圆孔未闭相关：一项美国全国性分析
The Modified Risk of Paradoxical Embolism Score Is Associated with Patent Foramen Ovale in Patients with Ischemic Stroke: A Nationwide US Analysis.
作者信息
Kwok Chun Shing, Alisiddiq Zaheer, Will Maximilian, Schwarz Konstantin, Khoo Chee, Large Adrian, Butler Robert, Lip Gregory Y H, Qureshi Adnan I, Borovac Josip Andelo
机构信息
Department of Cardiology, University Hospitals of North Midlands NHS Foundation Trust, Stoke-on-Trent ST4 6QG, UK.
Department of Internal Medicine 3, University Hospital St. Pölten, Karl Landsteiner University of Health Sciences, 3100 Krems, Austria.
出版信息
J Cardiovasc Dev Dis. 2024 Jul 5;11(7):213. doi: 10.3390/jcdd11070213.
BACKGROUND
The Risk of Paradoxical Embolism (RoPE) score was developed to identify stroke-related patent foramen ovale (PFO) in patients with cryptogenic stroke.
METHODS
We conducted a retrospective analysis of the 2016 to 2020 National Inpatient Sample to determine the performance of the modified RoPE score in identifying the presence of a PFO in patients with acute ischemic stroke (AIS).
RESULTS
A total of 3,338,805 hospital admissions for AIS were analysed and 3.0% had PFO. Patients with PFO were younger compared to those without a PFO (median 63 years vs. 71 years, < 0.001) and fewer were female (46.1% vs. 49.7%, < 0.001). The patients with PFO had greater mean modified RoPE scores (4.0 vs. 3.3, < 0.001). The area under the curve for the RoPE score in predicting PFOs was 0.625 (95%CI 0.620-0.629). The best diagnostic power of the RoPE score was achieved with a cut-off point of ≥4 where the sensitivity was 55% and the specificity was 64.2%. A cut-off point of ≥5 increased the specificity (83.1%) at the expense of sensitivity (35.8%). The strongest predictor of PFOs was deep vein thrombosis (OR 3.97, 95%CI 3.76-4.20).
CONCLUSIONS
The modified RoPE score had modest predictive value in identifying patients with PFO among patients admitted with AIS.
背景
矛盾栓塞风险（RoPE）评分旨在识别不明原因卒中患者中与卒中相关的卵圆孔未闭（PFO）。
方法
我们对2016年至2020年全国住院患者样本进行了回顾性分析，以确定改良RoPE评分在识别急性缺血性卒中（AIS）患者中PFO存在情况的性能。
结果
共分析了3338805例AIS住院病例，其中3.0%存在PFO。与无PFO的患者相比，有PFO的患者更年轻（中位年龄63岁对71岁，<0.001），女性患者更少（46.1%对49.7%，<0.001）。有PFO的患者平均改良RoPE评分更高（4.0对3.3，<0.001）。RoPE评分预测PFO的曲线下面积为0.625（95%CI 0.620 - 0.629）。RoPE评分的最佳诊断效能在截断点≥4时实现，此时敏感性为55%，特异性为64.2%。截断点≥5可提高特异性（83.1%），但敏感性降低（35.8%）。PFO的最强预测因素是深静脉血栓形成（OR 3.97，95%CI 3.76 - 4.20）。
结论
改良RoPE评分在识别AIS住院患者中的PFO患者方面具有中等预测价值。
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