Lactic acidosis and severe septic shock in metformin users: a cohort study.
Crit Care
; 20: 10, 2016 Jan 15.
Article
em En
| MEDLINE
| ID: mdl-26775158
ABSTRACT
BACKGROUND:
High serum lactate is associated with increased mortality in septic shock patients. Metformin alters lactate metabolism, and may affect its prognostic value. We compared, between metformin users and nonusers, the prognosis of extremely elevated plasma lactate levels in patients with septic shock.METHODS:
The electronic medical records (EMR) of patients admitted to the emergency room between January 2011 and June 2013 were reviewed. The study cohort comprised patients with an initial diagnosis of septic shock and blood lactate higher than 10 mmol/L. The selected population was divided into two groups metformin users (exposed) and metformin nonusers (unexposed). The primary outcome measured was inhospital mortality.RESULTS:
The study included 44 metformin users and 118 nonusers. Metformin users were similar to nonusers with respect to levels of lactate, HCO3, and blood pH; however, they were older and had higher incidence rates of cardiovascular disease and acute kidney injury at admission, compared to nonusers. Inhospital mortality rates were significantly lower in the metformin-treated group, 56.8 % vs. 88.1 %, p <0.0001.CONCLUSIONS:
Though high lactate concentration indicates poor prognosis in septic patients, mortality rate was found to be significantly lower in those who were treated with metformin. This finding may help clinicians in deciding treatment for these patients, who could otherwise be considered too ill for real treatment benefit.
Texto completo:
1
Bases de dados:
MEDLINE
Assunto principal:
Choque Séptico
/
Acidose Láctica
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Metformina
Tipo de estudo:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Crit Care
Ano de publicação:
2016
Tipo de documento:
Article
País de afiliação:
Israel