# Evaluation of the Wells score in predicting the incidence of stroke-associated pneumonia: the REMISE study

## TL;DR

This study shows that the Wells score, used to assess thrombosis risk, can predict the likelihood of stroke-associated pneumonia in patients.

## Contribution

The study demonstrates the Wells score's utility in predicting stroke-associated pneumonia risk, beyond existing tools.

## Key findings

- Higher Wells scores correlated with increased stroke-associated pneumonia incidence (16.8% vs. 58.4%).
- Medium and high Wells score groups had 2.48 and 3.49 times higher SAP risk, respectively.
- Adding the Wells score to the A2DS2 score improved SAP prediction accuracy.

## Abstract

Stroke-associated pneumonia (SAP) is a common complication in patients with stroke and is strongly associated with increased mortality and disability. Thrombotic burden may serve as a potential predictor of SAP. The Wells score, widely used to estimate the probability of thrombosis, offers a practical measure of thrombotic burden. This study aimed to investigate the utility of the Wells score in predicting the risk of SAP.

A total of 755 adult patients diagnosed were retrospectively included. Patients were stratified based on the Wells score into three groups: low risk group (score 0), medium risk group (score 1–2), and high risk group (score ≥3). Multivariate logistic regression analysis was performed to examine the association between the Wells score and the incidence of SAP.

A total of 260 patients developed SAP during hospitalization. With the increasing Wells scores, the proportion of SAP showed a rising trend (the low vs. medium vs. high risk group: 16.8% vs. 39.0% vs. 58.4%, p < 0.001). Multivariate logistic regression analysis showed that, compared to the low risk group, patients in the medium (odds ratio [OR]: 2.48, p < 0.001) and high risk group (OR: 3.49, p < 0.001) had more increased risks of SAP, respectively. The addition of the Wells score to A2DS2 score for SAP improved area under ROC curve.

A high thrombotic burden is commonly observed in IS patients and is associated with an increased risk of SAP. Further research is needed to clarify the underlying mechanisms.