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The antibiotic regimen was adapted to the organisms recovered from the sternal wound and continued for an overall treatment duration of 4�C6?weeks. Hospital records were reviewed retrospectively. The time to onset was defined as the interval between the initial surgical procedure and surgical debridement for mediastinitis. Early-onset and late-onset PSM were defined using a 14-day cut-off, as previously suggested by El Oakley et?al. [4]. Obesity was defined as a body weight greater than 20% of normal weight, as estimated by the Lorentz formula. Diabetes was defined as the need for medication with an antidiabetic drug. Preoperative renal insufficiency was determined by serum creatinine levels higher selleck screening library than 1.5?mg/dL (130?��mol/L). Septic shock was defined according to the ACCP/SCCM Consensus Conference [8]. Life-threatening complications recorded included secondary prosthetic valve endocarditis, massive mediastinal haemorrhage caused by vascular or cardiac rupture, and occurrence of septic shock or multiple organ dysfunctions. Treatment failure was defined as the inability of the technique to resolve local infection and leading to reoperation, or as death of the patient as a consequence of mediastinal infection. Superinfection was defined as the occurrence of a subsequent episode of PSM in which find more a different pathogen was isolated. Complete follow-up information was available for all 197 included patients, for a median follow-up duration of 19?months. Statistical analysis was performed using SPSS Base 10.0 statistical software (SPSS Inc, Chicago, IL, USA). Continuous variables were expressed as the median?(interquartile range) and were compared using the Mann�CWhitney U-test. Categorical Vatalanib (PTK787) 2HCl variables, expressed as percentages, were analysed with a chi-square test or Fisher��s exact test. Survival data were analysed with standard Kaplan�CMeier actuarial techniques for estimation of survival probabilities. To identify risk factors for 1-year mortality, overall mortality, mediastinitis-related death and treatment failure, univariate analysis of preoperative, procedure-related and mediastinitis-related variables was performed by comparing different subsets of patients. To evaluate independent risk factors for adverse outcome, significant univariate risk factors were examined by multiple regression procedures using backward stepwise logistic regression analysis and Cox regression. We considered that we could enter a maximum number of six variables in each model, in view of the number of events observed [9,10]. Coefficients were computed by the method of maximum likelihood. p?