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Risk factors of DAIR failure and validation of the KLIC score

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dc.contributor.authorHernández Torres, Alicia
dc.contributor.authorBernaus M, Rubio Á, Soriano A, et al
dc.contributor.authorBernaus, Martí
dc.contributor.authorAuñón-Rubio, Álvaro
dc.contributor.authorMonfort-Mira, Montserrat
dc.contributor.authorArteagoitia-Colino, Iaria
dc.contributor.authorMartínez-Ros, Javier
dc.contributor.authorCastellanos, Juan
dc.contributor.authorLamo Espinosa, José María
dc.contributor.authorArgüelles, Francisco
dc.contributor.authorVeloso, Margarita
dc.contributor.authorGómez García, Lucía
dc.contributor.authorAnglès Crespo, Francesc
dc.contributor.authorSánchez Fernández, Joel
dc.contributor.authorMurias Álvarez, Juan
dc.contributor.authorMartí Garín, David
dc.contributor.authorHernández-González, Nerea
dc.contributor.authorVillarejo Fernández, Borja
dc.contributor.authorValero Cifuentes, Gregorio
dc.contributor.authorMolina-González, José
dc.contributor.authorCoifman-Lucena, Ismael
dc.contributor.authorEsteban-Moreno, Jaime
dc.contributor.authorDemaria, Pablo
dc.contributor.authorEsteve-Palau, Erika
dc.contributor.authorPozo, José Luis del
dc.contributor.authorSuárez, Álvaro
dc.contributor.authorCarmona Torre, Francisco
dc.contributor.authorDarás, Álvaro
dc.contributor.authorBaeza, José
dc.contributor.authorFont Vizcarra, Lluís
dc.contributor.departmentMedicina
dc.date.accessioned2026-02-28T23:04:52Z
dc.date.available2026-02-28T23:04:52Z
dc.date.copyright© 2022 Mary Ann Liebert Inc.
dc.date.issued2022-03-24
dc.description.abstractBackground: Debridement, antibiotic agents, and implant retention (DAIR) is a currently accepted approach for the treatment of early prosthetic joint infections (PJI). The success of a DAIR procedure has shown variable results throughout the published literature. Scoring systems such as the Kidney, Liver, Index surgery, Cemented prosthesis, and C-reactive protein value (KLIC) score for the selection of patients that are likely to benefit from DAIR have proved to be helpful in decision making. Our study aims to further validate the KLIC score using a large external multicentric cohort and to evaluate other risk factors for failure. Patients and Methods: A retrospective analysis of patients with an early acute PJI who were treated with DAIR and recorded in a database of eight Spanish university hospitals was performed. According to pre-operative variables of the KLIC study, patients were categorized into five groups: group A, ≤2 points; group B, 2.5–3.5 points; group C, 4–5 points; group D, 5.5–6.5 points; and group E, ≥7 points. Failure rates were compared between groups at 60 days and after 60 days of DAIR. Further variables for risk of failure were also analyzed. Results: A total of 455 patients with early acute PJI were included in the analyses. At 60 days, patients presenting with pre-operative elevated C-reactive protein serum levels, Staphylococcus aureus, and polymicrobial infections were associated with failure. Failure rates recorded were 12% for group A (n = 210), 18% for group B (n = 83), 26% for group C (n = 89), 24% for group D (n = 66), and 0% for group E (n = 7). Univariable analysis between consecutive groups of the KLIC score showed no differences for failure before 60 days of the DAIR procedure. Scheduled surgery and having the procedure performed by a specialized unit were also identified as important factors for DAIR success. Conclusions: Our results suggest the KLIC score was not useful for predicting failure in our cohort. Furthermore, our results indicate a specialized unit should conduct DAIR procedures.
dc.formatapplication/pdf
dc.identifier.citationSurgical Infections. 2022;23(3):280-287
dc.identifier.doihttps://doi.org/10.1089/sur.2021.320
dc.identifier.eissn1557-8674
dc.identifier.issn1096-2964
dc.identifier.urihttp://hdl.handle.net/10201/216561
dc.languageeng
dc.publisherSAGE Publications
dc.relationSin financiación externa a la Universidad
dc.relation.publisherversionhttps://journals.sagepub.com/doi/10.1089/sur.2021.320
dc.rights.accessRightsinfo:eu-repo/semantics/restrictedAccess
dc.subjectAntibiotics
dc.subjectDebridement
dc.subjectKLIC score
dc.subjectProsthetic joint infection
dc.subjectValidation
dc.subject.odsObjetivo 3: Salud
dc.titleRisk factors of DAIR failure and validation of the KLIC score
dc.typeinfo:eu-repo/semantics/article
dc.type.versioninfo:eu-repo/semantics/publishedVersion
dspace.entity.typePublicationes
relation.isAuthorOfPublication09538523-5951-4b1b-9370-9e756eac67fa
relation.isAuthorOfPublication.latestForDiscovery09538523-5951-4b1b-9370-9e756eac67fa
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