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Metformin Affects Serum Lactate Levels in Predicting Mortality of Patients with Sepsis and Bacteremia

This study determined if the use of metformin affected the prognostic value of hyperlactatemia in predicting 28-day mortality among patients with sepsis and bacteremia. We enrolled adult diabetic patients with sepsis and bacteremia. Of 590 patients, 162 and 162 metformin users and nonusers, respecti...

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Autores principales: Chen, Fu-Cheng, Kung, Chia-Te, Cheng, Hsien-Hung, Cheng, Chi-Yung, Tsai, Tsung-Cheng, Hsiao, Sheng-Yuan, Wu, Chien-Hung, Su, Chih-Min
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6463016/
https://www.ncbi.nlm.nih.gov/pubmed/30845747
http://dx.doi.org/10.3390/jcm8030318
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author Chen, Fu-Cheng
Kung, Chia-Te
Cheng, Hsien-Hung
Cheng, Chi-Yung
Tsai, Tsung-Cheng
Hsiao, Sheng-Yuan
Wu, Chien-Hung
Su, Chih-Min
author_facet Chen, Fu-Cheng
Kung, Chia-Te
Cheng, Hsien-Hung
Cheng, Chi-Yung
Tsai, Tsung-Cheng
Hsiao, Sheng-Yuan
Wu, Chien-Hung
Su, Chih-Min
author_sort Chen, Fu-Cheng
collection PubMed
description This study determined if the use of metformin affected the prognostic value of hyperlactatemia in predicting 28-day mortality among patients with sepsis and bacteremia. We enrolled adult diabetic patients with sepsis and bacteremia. Of 590 patients, 162 and 162 metformin users and nonusers, respectively, were selected in propensity matching. The mean serum lactate levels in metformin users were higher than those in nonusers (4.7 vs. 3.9 mmol/L, p = 0.044). We divided the patients into four groups based on quick Sepsis-related Organ Failure Assessment (qSOFA) scores. No significant difference was found among nonusers with qSOFA score <2, nonusers with qSOFA score ≥2, and metformin users with qSOFA score <2. The lactate levels in metformin users with qSOFA score ≥2 were higher than those in other groups, and significant differences were found in both nonsurvivors (8.9 vs. 4.6 mmol/L, p = 0.027) and survivors (6.4 vs. 3.8 mmol/L, p = 0.049) compared with metformin users with qSOFA score <2. The best cut-off point to predict 28-day mortality in metformin users (5.9 mmol/L; area under the receiver operating characteristic curve (AUROC), 0.66; 95% confidence interval (CI), 0.55–0.77) was higher than that in nonusers (3.6 mmol/L; AUROC 0.63; 95% CI, 0.56–0.70). Metformin users had higher lactate levels than nonusers in increasing sepsis severity. Serum lactate levels could be useful in predicting mortality in patients using metformin, but higher levels are required to obtain more precise results.
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spelling pubmed-64630162019-04-19 Metformin Affects Serum Lactate Levels in Predicting Mortality of Patients with Sepsis and Bacteremia Chen, Fu-Cheng Kung, Chia-Te Cheng, Hsien-Hung Cheng, Chi-Yung Tsai, Tsung-Cheng Hsiao, Sheng-Yuan Wu, Chien-Hung Su, Chih-Min J Clin Med Article This study determined if the use of metformin affected the prognostic value of hyperlactatemia in predicting 28-day mortality among patients with sepsis and bacteremia. We enrolled adult diabetic patients with sepsis and bacteremia. Of 590 patients, 162 and 162 metformin users and nonusers, respectively, were selected in propensity matching. The mean serum lactate levels in metformin users were higher than those in nonusers (4.7 vs. 3.9 mmol/L, p = 0.044). We divided the patients into four groups based on quick Sepsis-related Organ Failure Assessment (qSOFA) scores. No significant difference was found among nonusers with qSOFA score <2, nonusers with qSOFA score ≥2, and metformin users with qSOFA score <2. The lactate levels in metformin users with qSOFA score ≥2 were higher than those in other groups, and significant differences were found in both nonsurvivors (8.9 vs. 4.6 mmol/L, p = 0.027) and survivors (6.4 vs. 3.8 mmol/L, p = 0.049) compared with metformin users with qSOFA score <2. The best cut-off point to predict 28-day mortality in metformin users (5.9 mmol/L; area under the receiver operating characteristic curve (AUROC), 0.66; 95% confidence interval (CI), 0.55–0.77) was higher than that in nonusers (3.6 mmol/L; AUROC 0.63; 95% CI, 0.56–0.70). Metformin users had higher lactate levels than nonusers in increasing sepsis severity. Serum lactate levels could be useful in predicting mortality in patients using metformin, but higher levels are required to obtain more precise results. MDPI 2019-03-06 /pmc/articles/PMC6463016/ /pubmed/30845747 http://dx.doi.org/10.3390/jcm8030318 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Chen, Fu-Cheng
Kung, Chia-Te
Cheng, Hsien-Hung
Cheng, Chi-Yung
Tsai, Tsung-Cheng
Hsiao, Sheng-Yuan
Wu, Chien-Hung
Su, Chih-Min
Metformin Affects Serum Lactate Levels in Predicting Mortality of Patients with Sepsis and Bacteremia
title Metformin Affects Serum Lactate Levels in Predicting Mortality of Patients with Sepsis and Bacteremia
title_full Metformin Affects Serum Lactate Levels in Predicting Mortality of Patients with Sepsis and Bacteremia
title_fullStr Metformin Affects Serum Lactate Levels in Predicting Mortality of Patients with Sepsis and Bacteremia
title_full_unstemmed Metformin Affects Serum Lactate Levels in Predicting Mortality of Patients with Sepsis and Bacteremia
title_short Metformin Affects Serum Lactate Levels in Predicting Mortality of Patients with Sepsis and Bacteremia
title_sort metformin affects serum lactate levels in predicting mortality of patients with sepsis and bacteremia
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6463016/
https://www.ncbi.nlm.nih.gov/pubmed/30845747
http://dx.doi.org/10.3390/jcm8030318
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