Does metformin exposure before ICU stay have any impact on patients’ outcome? A retrospective cohort study of diabetic patients

Does metformin exposure before ICU stay have any impact on patients’ outcome? A retrospective... Background: Impact of metformin exposure before ICU stay remains controversial. Metformin is thought to induce lactic acidosis and haemodynamic instability but may reduce ICU mortality. We evaluated its influence on outcome in diabetic patients admitted in the ICU and then compared two different populations based on the presence of septic shock. Methods: We conducted a retrospective cohort study in a 24‑ bed French ICU between October 2010 and December 2013, including all ICU‑ admitted diabetic patients. Results: Among 635 diabetic patients admitted during the study period, 131 (21%) were admitted with septic shock. Multivariate analysis showed no difference in hospital mortality in all metformin users (OR 0.75 [95% CI 0.44–1.28]; p = 0.29), except in the septic shock subgroup (OR 0.61; 95% CI [0.37–0.99]; p = 0.04) despite higher vasopressor dosages in the first hours after shock onset. Blood lactate level was higher in metformin users than in non ‑ metformin users in all patients (p < 0.001), in septic shock patients (p < 0.001) and in patients without kidney injury (p < 0.001). Metformin users did not have more septic shock from unknown aetiology (p = 0.65) or unknown pathogen (p = 0.99). Conclusions: Metformin use before admission http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Annals of Intensive Care Springer Journals

Does metformin exposure before ICU stay have any impact on patients’ outcome? A retrospective cohort study of diabetic patients

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Publisher
Springer International Publishing
Copyright
Copyright © 2017 by The Author(s)
Subject
Medicine & Public Health; Intensive / Critical Care Medicine; Emergency Medicine; Anesthesiology
eISSN
2110-5820
D.O.I.
10.1186/s13613-017-0336-8
Publisher site
See Article on Publisher Site

Abstract

Background: Impact of metformin exposure before ICU stay remains controversial. Metformin is thought to induce lactic acidosis and haemodynamic instability but may reduce ICU mortality. We evaluated its influence on outcome in diabetic patients admitted in the ICU and then compared two different populations based on the presence of septic shock. Methods: We conducted a retrospective cohort study in a 24‑ bed French ICU between October 2010 and December 2013, including all ICU‑ admitted diabetic patients. Results: Among 635 diabetic patients admitted during the study period, 131 (21%) were admitted with septic shock. Multivariate analysis showed no difference in hospital mortality in all metformin users (OR 0.75 [95% CI 0.44–1.28]; p = 0.29), except in the septic shock subgroup (OR 0.61; 95% CI [0.37–0.99]; p = 0.04) despite higher vasopressor dosages in the first hours after shock onset. Blood lactate level was higher in metformin users than in non ‑ metformin users in all patients (p < 0.001), in septic shock patients (p < 0.001) and in patients without kidney injury (p < 0.001). Metformin users did not have more septic shock from unknown aetiology (p = 0.65) or unknown pathogen (p = 0.99). Conclusions: Metformin use before admission

Journal

Annals of Intensive CareSpringer Journals

Published: Dec 2, 2017

References

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