Association between metformin use and reduced short- and long-term all-cause mortality in patients undergoing cardiac surgery: a retrospective cohort study
Abstract
AIMS: The use of metformin during the perioperative period remains a contentious issue. This study aimed to assess the impact of metformin use on overall mortality rates among patients in postoperative cardiac intensive care units.
MATERIALS AND METHODS: This study retrospectively analyzed data from 8675 cardiac surgery patients sourced from the Medical Information Marketplace in Intensive Care (MIMIC 3.0) database. The administration of metformin during the postoperative ICU stay was assessed. Utilizing Cox proportional hazards modeling, the study explored the correlation between metformin treatment and all-cause mortality (ACM). The impact of metformin on survival rates was examined using the Kaplan-Meier method. Subgroup analyses and interaction tests were conducted to ascertain the consistency of these associations across diverse demographic and clinical subgroups.
RESULTS: The average age of participants in this study was 69.0 years, spanning from 61.0 to 76.0 years. A higher proportion of individuals who received metformin following surgery were male (75.6% vs 72.3%, P = 0.01), younger (67.19 ± 9.26 vs 67.95 ± 11.75, P = 0.006), and had lower Sequential Organ Failure Assessment Scores (4.92 ± 2.38 vs 5.31 ± 2.79, P < 0.001). When compared with patients who did not receive metformin after surgery, these individuals who received metformin following surgery had a lower prevalence of chronic kidney disease, congestive heart failure, and peripheral vascular disease and the…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 8,675 participants or records.
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