Association of preadmission metformin use and prognosis in patients with sepsis with diabetes: a systematic review and meta-analysis - Summary - MDSpire
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Association of preadmission metformin use and prognosis in patients with sepsis with diabetes: a systematic review and meta-analysis
To evaluate the impact of preadmission metformin use on mortality outcomes in diabetic patients with sepsis, focusing on the quality and consistency of existing evidence.
Key Findings:
Preadmission metformin use associated with reduced overall mortality (OR 0.58, 95% CI 0.44–0.75, P < 0.00001).
Significant reductions in 28-day (OR 0.61, P = 0.002), 90-day (OR 0.48, P = 0.001), 365-day (OR 0.33, P = 0.0005), and in-hospital mortality (OR 0.43, P < 0.02).
No significant differences in 30-day (OR 0.71, P = 0.06), 60-day (OR 0.72, P = 0.22), and ICU mortality (OR 0.76, P = 0.25).
Metformin improved serum creatinine levels (MD −0.32, P = 0.04) but was associated with elevated serum lactate levels, which may indicate metabolic stress.
Interpretation:
Preadmission metformin use in diabetic sepsis patients is linked to lower mortality rates, suggesting its potential as a favorable prognostic indicator and highlighting the need for its consideration in clinical practice.
Limitations:
Variability in study designs and patient populations.
Potential confounding factors not fully accounted for in all studies.
Risk of publication bias affecting the overall findings.
Conclusion:
The findings support the integration of metformin history into clinical guidelines for diabetic sepsis patients, warranting further investigation through large-scale randomized controlled trials to confirm these benefits.
