Some questions about preadmission metformin use and mortality in patients with sepsis and diabetes mellitus

Ye, Jiarong; Liang, Qianrong; Xi, Xiaotu

doi:10.1186/s13054-019-2392-y

Cited by 3 publications

(3 citation statements)

References 5 publications

(5 reference statements)

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“…Their results are akin to our findings. However, this meta-analysis only enrolled 1,282 patients ( 26 ) and still overlooked several important confounders, such as serum glucose levels, differences baselines in the SAPS II ( 27 ), and RRT in both arms ( 28 ). Our study had a much larger cohort ( n = 2,383) and used an extended model approach to adjust the potential confounders and found a stable relationship between preadmission metformin use and 30-day mortality.…”

Section: Discussionmentioning

confidence: 99%

Association Between Preadmission Metformin Use and Outcomes in Intensive Care Unit Patients With Sepsis and Type 2 Diabetes: A Cohort Study

et al. 2021

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Background: Sepsis is a deadly disease worldwide. Effective treatment strategy of sepsis remains limited. There still was a controversial about association between preadmission metformin use and mortality in sepsis patients with diabetes. We aimed to assess sepsis-related mortality in patients with type 2 diabetes (T2DM) who were preadmission metformin and non-metformin users.Methods: The patients with sepsis and T2DM were included from Medical Information Mart for Intensive Care -III database. Outcome was 30-day mortality. We used multivariable Cox regression analyses to calculate adjusted hazard ratio (HR) with 95% CI.Results: We included 2,383 sepsis patients with T2DM (476 and 1,907 patients were preadmission metformin and non-metformin uses) between 2001 and 2012. The overall 30-day mortality was 20.1% (480/2,383); it was 21.9% (418/1,907), and 13.0% (62/476) for non-metformin and metformin users, respectively. After adjusted for potential confounders, we found that preadmission metformin use was associated with 39% lower of 30-day mortality (HR = 0.61, 95% CI: 0.46–0.81, p = 0.007). In sensitivity analyses, subgroups analyses, and propensity score matching, the results remain stable.Conclusions: Preadmission metformin use may be associated with reduced risk-adjusted mortality in patients with sepsis and T2DM. It is worthy to further investigate this association.

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Section: Discussionmentioning

confidence: 99%

Association Between Preadmission Metformin Use and Outcomes in Intensive Care Unit Patients With Sepsis and Type 2 Diabetes: A Cohort Study

et al. 2021

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“…Our data were based on patient‐reported chronic medication use. We did not possess data on premorbid glycaemic control and glycaemic variability during ICU stay, although this might also impact mortality 44,45 …”

Section: Resultsmentioning

confidence: 99%

“…We did not possess data on premorbid glycaemic control and glycaemic variability during ICU stay, although this might also impact mortality. 44,45 Fourth, lactate measurements were not routinely repeated in the first hours after arrival in the ED, making it impossible to analyse lactate kinetics over shorter time frames. This might have provided additional information as the systematic review of Vincent et al…”

Section: Strengths and Limitationsmentioning

confidence: 99%