Association of metformin administration after septic shock with short-term and long-term survival in septic shock patients with diabetes
Abstract Background In addition to glycemic control, the anti-inflammatory effects and protective effect of metformin on sepsis have been reported in animal studies, which may be beneficial for patients with septic shock. Few observational studies have evaluated metformin administration after sepsis...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SpringerOpen
2025-05-01
|
| Series: | Annals of Intensive Care |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13613-025-01490-8 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849325881493815296 |
|---|---|
| author | Bo-Yeong Jin Sukyo Lee Woosik Kim Jong-Hak Park Hanjin Cho Sungwoo Moon Sejoong Ahn |
| author_facet | Bo-Yeong Jin Sukyo Lee Woosik Kim Jong-Hak Park Hanjin Cho Sungwoo Moon Sejoong Ahn |
| author_sort | Bo-Yeong Jin |
| collection | DOAJ |
| description | Abstract Background In addition to glycemic control, the anti-inflammatory effects and protective effect of metformin on sepsis have been reported in animal studies, which may be beneficial for patients with septic shock. Few observational studies have evaluated metformin administration after sepsis or bacteremia; however, these studies did not specifically analyze septic shock or long-term outcomes. Therefore, this study aimed to evaluate the associations between metformin administration after septic shock and the short- and long-term survival in septic shock patients with type 2 diabetes mellitus. Method This retrospective observational study used data from a prospectively collected sepsis registry. From October 2016 to June 2022, adult septic shock patients with type 2 diabetes mellitus were included in this study. The variable of interest was metformin administration within 48 h after diagnosis of septic shock. The 90-day mortality and 365-day mortality were evaluated as outcomes. A multivariable Cox proportional hazards model was conducted. Results A total of 320 patients were included in the study. Metformin administration within 48 h after diagnosis of septic shock was associated with lower 90-day mortality (13.0% vs. 39.8%, P < 0.001), 365-day mortality (23.3% vs. 48.3%, P = 0.001), and in-hospital mortality (9.3% vs. 28.6%, P = 0.002) than those who did not administer metformin within 48 h. Metformin administration within 48 h was independently associated with decreased 90-day mortality (adjusted hazard ratio [aHR]: 0.371, 95% confidence interval [CI]: 0.153–0.900, P = 0.028) and 365-day mortality (aHR 0.453, 95% CI 0.219–0.937, P = 0.033) after adjusting for potential confounders. Similar results were found for metformin administration within 72 h after septic shock (aHR 0.433, 95% CI 0.235–0.797, P = 0.007 for 90-day mortality and aHR 0.450, 95% CI 0.264–0.767, P = 0.003 for 365-day mortality). Conclusions In septic shock patients with type 2 diabetes mellitus, metformin administration within 48 h was associated with lower 90-day and 365-day mortality. While these findings suggest potential benefits of metformin administration after septic shock, further large, multicenter studies are warranted. |
| format | Article |
| id | doaj-art-33fd8b7d13bf4979b018464afce2ce99 |
| institution | Kabale University |
| issn | 2110-5820 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Annals of Intensive Care |
| spelling | doaj-art-33fd8b7d13bf4979b018464afce2ce992025-08-20T03:48:18ZengSpringerOpenAnnals of Intensive Care2110-58202025-05-0115111110.1186/s13613-025-01490-8Association of metformin administration after septic shock with short-term and long-term survival in septic shock patients with diabetesBo-Yeong Jin0Sukyo Lee1Woosik Kim2Jong-Hak Park3Hanjin Cho4Sungwoo Moon5Sejoong Ahn6Department of Biomedical Sciences, Seoul National University College of MedicineDepartment of Emergency Medicine, Korea University Ansan HospitalDepartment of Emergency Medicine, Korea University Ansan HospitalDepartment of Emergency Medicine, Korea University Ansan HospitalDepartment of Emergency Medicine, Korea University Ansan HospitalDepartment of Emergency Medicine, Korea University Ansan HospitalDepartment of Emergency Medicine, Korea University Ansan HospitalAbstract Background In addition to glycemic control, the anti-inflammatory effects and protective effect of metformin on sepsis have been reported in animal studies, which may be beneficial for patients with septic shock. Few observational studies have evaluated metformin administration after sepsis or bacteremia; however, these studies did not specifically analyze septic shock or long-term outcomes. Therefore, this study aimed to evaluate the associations between metformin administration after septic shock and the short- and long-term survival in septic shock patients with type 2 diabetes mellitus. Method This retrospective observational study used data from a prospectively collected sepsis registry. From October 2016 to June 2022, adult septic shock patients with type 2 diabetes mellitus were included in this study. The variable of interest was metformin administration within 48 h after diagnosis of septic shock. The 90-day mortality and 365-day mortality were evaluated as outcomes. A multivariable Cox proportional hazards model was conducted. Results A total of 320 patients were included in the study. Metformin administration within 48 h after diagnosis of septic shock was associated with lower 90-day mortality (13.0% vs. 39.8%, P < 0.001), 365-day mortality (23.3% vs. 48.3%, P = 0.001), and in-hospital mortality (9.3% vs. 28.6%, P = 0.002) than those who did not administer metformin within 48 h. Metformin administration within 48 h was independently associated with decreased 90-day mortality (adjusted hazard ratio [aHR]: 0.371, 95% confidence interval [CI]: 0.153–0.900, P = 0.028) and 365-day mortality (aHR 0.453, 95% CI 0.219–0.937, P = 0.033) after adjusting for potential confounders. Similar results were found for metformin administration within 72 h after septic shock (aHR 0.433, 95% CI 0.235–0.797, P = 0.007 for 90-day mortality and aHR 0.450, 95% CI 0.264–0.767, P = 0.003 for 365-day mortality). Conclusions In septic shock patients with type 2 diabetes mellitus, metformin administration within 48 h was associated with lower 90-day and 365-day mortality. While these findings suggest potential benefits of metformin administration after septic shock, further large, multicenter studies are warranted.https://doi.org/10.1186/s13613-025-01490-8Septic shockType 2 diabetes mellitusMetforminDiabetic medicationBiguanideSurvival |
| spellingShingle | Bo-Yeong Jin Sukyo Lee Woosik Kim Jong-Hak Park Hanjin Cho Sungwoo Moon Sejoong Ahn Association of metformin administration after septic shock with short-term and long-term survival in septic shock patients with diabetes Annals of Intensive Care Septic shock Type 2 diabetes mellitus Metformin Diabetic medication Biguanide Survival |
| title | Association of metformin administration after septic shock with short-term and long-term survival in septic shock patients with diabetes |
| title_full | Association of metformin administration after septic shock with short-term and long-term survival in septic shock patients with diabetes |
| title_fullStr | Association of metformin administration after septic shock with short-term and long-term survival in septic shock patients with diabetes |
| title_full_unstemmed | Association of metformin administration after septic shock with short-term and long-term survival in septic shock patients with diabetes |
| title_short | Association of metformin administration after septic shock with short-term and long-term survival in septic shock patients with diabetes |
| title_sort | association of metformin administration after septic shock with short term and long term survival in septic shock patients with diabetes |
| topic | Septic shock Type 2 diabetes mellitus Metformin Diabetic medication Biguanide Survival |
| url | https://doi.org/10.1186/s13613-025-01490-8 |
| work_keys_str_mv | AT boyeongjin associationofmetforminadministrationaftersepticshockwithshorttermandlongtermsurvivalinsepticshockpatientswithdiabetes AT sukyolee associationofmetforminadministrationaftersepticshockwithshorttermandlongtermsurvivalinsepticshockpatientswithdiabetes AT woosikkim associationofmetforminadministrationaftersepticshockwithshorttermandlongtermsurvivalinsepticshockpatientswithdiabetes AT jonghakpark associationofmetforminadministrationaftersepticshockwithshorttermandlongtermsurvivalinsepticshockpatientswithdiabetes AT hanjincho associationofmetforminadministrationaftersepticshockwithshorttermandlongtermsurvivalinsepticshockpatientswithdiabetes AT sungwoomoon associationofmetforminadministrationaftersepticshockwithshorttermandlongtermsurvivalinsepticshockpatientswithdiabetes AT sejoongahn associationofmetforminadministrationaftersepticshockwithshorttermandlongtermsurvivalinsepticshockpatientswithdiabetes |