Association of preadmission metformin use and mortality in patients with sepsis and diabetes mellitus: A systematic review and meta-analysis of cohort studies 11 Medical and Health Sciences 1117 Public Health and Health Services

Huoyan Liang, Xianfei Ding, Lifeng Li, Tian Wang, Quancheng Kan, Lexin Wang, Tongwen Sun

Research output: Contribution to journalReview article

2 Citations (Scopus)
4 Downloads (Pure)

Abstract

Recent studies have reported that preadmission metformin users had lower mortality than non-metformin users in patients with sepsis and diabetes mellitus; however, these results are still controversial. Therefore, we conducted a systematic review and meta-analysis of published observational cohort data to determine the association between preadmission metformin use and mortality in septic adult patients with diabetes mellitus. Methods: The MEDLINE, EMBASE, and Cochrane CENTRAL databases were searched from their inception to September 30, 2018. Cohort studies that evaluated the use of metformin in septic adult patients with diabetes mellitus were included. The quality of outcomes was evaluated using the Newcastle-Ottawa Scale (NOS). The inverse variance method with random effects modelling was used to calculate the pooled odds ratios (ORs) and 95% CIs. Results: Five observational cohort studies (1282 patients) that were all judged as having a low risk of bias were included. In this meta-analysis, metformin use was associated with a significantly lower mortality rate (OR, 0.59; 95% CI, 0.43-0.79, P = 0.001). Conclusions: This meta-analysis indicated an association between metformin use prior to admission and lower mortality in septic adult patients with diabetes mellitus. This finding suggested that the possible effect of metformin should be evaluated in future clinical trials.
Original languageEnglish
Article number50
Pages (from-to)1-9
Number of pages9
JournalCritical Care (UK)
Volume23
Issue number1
DOIs
Publication statusPublished - 18 Feb 2019

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Metformin
Health Services
Meta-Analysis
Sepsis
Diabetes Mellitus
Cohort Studies
Public Health
Mortality
Health
Odds Ratio
MEDLINE
Observational Studies
Clinical Trials
Databases

Cite this

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title = "Association of preadmission metformin use and mortality in patients with sepsis and diabetes mellitus: A systematic review and meta-analysis of cohort studies 11 Medical and Health Sciences 1117 Public Health and Health Services",
abstract = "Recent studies have reported that preadmission metformin users had lower mortality than non-metformin users in patients with sepsis and diabetes mellitus; however, these results are still controversial. Therefore, we conducted a systematic review and meta-analysis of published observational cohort data to determine the association between preadmission metformin use and mortality in septic adult patients with diabetes mellitus. Methods: The MEDLINE, EMBASE, and Cochrane CENTRAL databases were searched from their inception to September 30, 2018. Cohort studies that evaluated the use of metformin in septic adult patients with diabetes mellitus were included. The quality of outcomes was evaluated using the Newcastle-Ottawa Scale (NOS). The inverse variance method with random effects modelling was used to calculate the pooled odds ratios (ORs) and 95{\%} CIs. Results: Five observational cohort studies (1282 patients) that were all judged as having a low risk of bias were included. In this meta-analysis, metformin use was associated with a significantly lower mortality rate (OR, 0.59; 95{\%} CI, 0.43-0.79, P = 0.001). Conclusions: This meta-analysis indicated an association between metformin use prior to admission and lower mortality in septic adult patients with diabetes mellitus. This finding suggested that the possible effect of metformin should be evaluated in future clinical trials.",
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author = "Huoyan Liang and Xianfei Ding and Lifeng Li and Tian Wang and Quancheng Kan and Lexin Wang and Tongwen Sun",
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Association of preadmission metformin use and mortality in patients with sepsis and diabetes mellitus : A systematic review and meta-analysis of cohort studies 11 Medical and Health Sciences 1117 Public Health and Health Services. / Liang, Huoyan; Ding, Xianfei; Li, Lifeng; Wang, Tian; Kan, Quancheng; Wang, Lexin; Sun, Tongwen.

In: Critical Care (UK), Vol. 23, No. 1, 50, 18.02.2019, p. 1-9.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Association of preadmission metformin use and mortality in patients with sepsis and diabetes mellitus

T2 - A systematic review and meta-analysis of cohort studies 11 Medical and Health Sciences 1117 Public Health and Health Services

AU - Liang, Huoyan

AU - Ding, Xianfei

AU - Li, Lifeng

AU - Wang, Tian

AU - Kan, Quancheng

AU - Wang, Lexin

AU - Sun, Tongwen

PY - 2019/2/18

Y1 - 2019/2/18

N2 - Recent studies have reported that preadmission metformin users had lower mortality than non-metformin users in patients with sepsis and diabetes mellitus; however, these results are still controversial. Therefore, we conducted a systematic review and meta-analysis of published observational cohort data to determine the association between preadmission metformin use and mortality in septic adult patients with diabetes mellitus. Methods: The MEDLINE, EMBASE, and Cochrane CENTRAL databases were searched from their inception to September 30, 2018. Cohort studies that evaluated the use of metformin in septic adult patients with diabetes mellitus were included. The quality of outcomes was evaluated using the Newcastle-Ottawa Scale (NOS). The inverse variance method with random effects modelling was used to calculate the pooled odds ratios (ORs) and 95% CIs. Results: Five observational cohort studies (1282 patients) that were all judged as having a low risk of bias were included. In this meta-analysis, metformin use was associated with a significantly lower mortality rate (OR, 0.59; 95% CI, 0.43-0.79, P = 0.001). Conclusions: This meta-analysis indicated an association between metformin use prior to admission and lower mortality in septic adult patients with diabetes mellitus. This finding suggested that the possible effect of metformin should be evaluated in future clinical trials.

AB - Recent studies have reported that preadmission metformin users had lower mortality than non-metformin users in patients with sepsis and diabetes mellitus; however, these results are still controversial. Therefore, we conducted a systematic review and meta-analysis of published observational cohort data to determine the association between preadmission metformin use and mortality in septic adult patients with diabetes mellitus. Methods: The MEDLINE, EMBASE, and Cochrane CENTRAL databases were searched from their inception to September 30, 2018. Cohort studies that evaluated the use of metformin in septic adult patients with diabetes mellitus were included. The quality of outcomes was evaluated using the Newcastle-Ottawa Scale (NOS). The inverse variance method with random effects modelling was used to calculate the pooled odds ratios (ORs) and 95% CIs. Results: Five observational cohort studies (1282 patients) that were all judged as having a low risk of bias were included. In this meta-analysis, metformin use was associated with a significantly lower mortality rate (OR, 0.59; 95% CI, 0.43-0.79, P = 0.001). Conclusions: This meta-analysis indicated an association between metformin use prior to admission and lower mortality in septic adult patients with diabetes mellitus. This finding suggested that the possible effect of metformin should be evaluated in future clinical trials.

KW - Diabetes mellitus

KW - Meta-analysis

KW - Metformin

KW - Mortality

KW - Sepsis

KW - Systematic review

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JO - Critical Care

JF - Critical Care

SN - 1364-8535

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