# Are KLIC and CRIME-80 scores useful to assist decision-making initially or at the moment of repeat DAIR? – a retrospective study

## TL;DR

This study found that KLIC and CRIME-80 scores do not reliably predict the success or failure of DAIR procedures for joint infections.

## Contribution

The study evaluates the clinical utility of KLIC and CRIME-80 scores in predicting DAIR failure in a real-world cohort.

## Key findings

- The overall DAIR failure rate was 35.3% with no significant difference between single and repeat procedures.
- KLIC and CRIME-80 scores showed no significant correlation with DAIR failure rates at initial or repeat treatments.
- The scores provided limited prognostic value and did not support clinical decision-making.

## Abstract

Introduction: Debridement, antibiotics, and implant retention (DAIR) is recommended for early acute postoperative and late acute periprosthetic joint infections (PJIs). The KLIC and CRIME-80 scores have been proposed to predict DAIR outcomes. Nevertheless, their clinical utility remains uncertain. This study aimed to evaluate their predictive value for DAIR failure in our cohort, both at primary indication and when repeat DAIR was considered necessary. Methods: We retrospectively reviewed all patients who underwent DAIR for total hip or knee PJI between 2010 and 2021, with at least 1 year of follow-up. Failure was defined as persistent infection, need for implant removal, amputation, or infection-related death. Results: A total of 102 patients were included, with a mean follow-up of 48.9 months. The overall failure rate was 35.3 %. Failure rates did not differ significantly between patients who underwent a single DAIR and those who required repeat procedures (32.5 % vs. 45.5 %,
p=
 0.26). No significant correlations were found between KLIC or CRIME-80 scores and failure rates, either at the initial indication for DAIR (
p=
 0.54 and
p=
 0.93, respectively) or in repeat DAIR procedures (
p=
 0.44 and
p=
 0.50, respectively). Conclusions: In our cohort, the KLIC and CRIME-80 scores were not predictive of DAIR failure, either at initial treatment or when repeat DAIR was required. These scores offered limited prognostic value and did not support clinical decision-making. Prospective studies are needed to validate and improve predictive tools for DAIR outcomes.