Evidence map›Paper›PMID 32166255›Full record

ReviewCritical care explorations2019

The Association of Premorbid Metformin Exposure With Mortality and Organ Dysfunction in Sepsis: A Systematic Review and Meta-Analysis.

Kaiquan Tan, Andrew Simpson, Stephen Huang, Benjamin Tang, Anthony Mclean, Marek Nalos

Open access · goldAbstract readReview

In one paragraph

Review in Critical care explorations, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it

0cells of the map it votes in

9citing papers in PubMed

1.4field-weighted citation impact, top 18% of its field

1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 15 citations in OpenAlex.

Immunometabolism, an emerging field in perioperative and critical care medicine: a narrative review.British journal of anaesthesia · 2026
Review
Dissociation between gut microbiota remodeling and early gut-liver injury in CLP-induced sepsis.Frontiers in pharmacology · 2026
Article
The immunology of sepsis: translating new insights into clinical practice.Nature reviews. Nephrology · 2026
Review
Metformin for sepsis-associated AKI: a protocol for the Randomized Clinical Trial of the Safety and FeasibiLity of Metformin as a Treatment for sepsis-associated AKI (LiMiT AKI).BMJ open · 2024
Article
The immunomodulatory effects of metformin in LPS-induced macrophages: an in vitro study.Inflammation research : official journal of the European Histamine Research Society ... [et al.] · 2024
Article
New potential for an old kid on the block: Impact of premorbid metformin use on lactate kinetics, kidney injury and mortality in sepsis and septic shock, an observational study.Endocrinology, diabetes & metabolism · 2023
Observational
Use of oral anti-diabetic drugs and risk of hospital and intensive care unit admissions for infections.The American journal of the medical sciences · 2022
Article
Acute glycemic variability and risk of mortality in patients with sepsis: a meta-analysis.Diabetology & metabolic syndrome · 2022
Article
Anti-Hyperglycemic Agents in the Adjuvant Treatment of Sepsis: Improving Intestinal Barrier Function.Drug design, development and therapy · 2022
Review

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

Kaiquan TanNepean Clinical School, Sydney Medical School, University of Sydney, Penrith, NSW, Australia.

Andrew SimpsonDepartment of Intensive Care Medicine, Nepean Hospital, Penrith, NSW, Australia.

Stephen HuangNepean Clinical School, Sydney Medical School, University of Sydney, Penrith, NSW, Australia.

Benjamin TangNepean Clinical School, Sydney Medical School, University of Sydney, Penrith, NSW, Australia.

Anthony McleanNepean Clinical School, Sydney Medical School, University of Sydney, Penrith, NSW, Australia.

Marek NalosNepean Clinical School, Sydney Medical School, University of Sydney, Penrith, NSW, Australia.

Nepean Hospital · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

To examine the association between premorbid metformin exposure and mortality, hyperlactatemia, and organ dysfunction in sepsis. DATA SOURCES: PubMed and EMBASE (with Medline via Ovid) databases were searched for all studies of premorbid metformin exposure and sepsis published between January 1974 and August 2018. STUDY SELECTION: Studies of at least 20 patients with sepsis that reported data on metformin use, mortality, and/or organ dysfunction were independently selected. DATA EXTRACTION: Two reviewers abstracted data on study design, settings, study quality, participants, metformin exposure, mortality, initial lactate levels, and organ dysfunction. Risk of bias was independently assessed. DATA SYNTHESIS: Eight observational studies fulfilled our criteria, comprising 4,144 patients with sepsis including 562 diabetics on metformin. Premorbid metformin exposure was associated with reduced mortality in sepsis (odds ratio, 0.57; 95% CI, 0.40-0.80). Between studies heterogeneity was low (

conclusionsThe meta-analysis suggests that premorbid metformin exposure is associated with decreased mortality in sepsis but not with hyperlactatemia. What are the potential mechanisms and whether there is any effect on organ dysfunction remain unclear.

Indexed as

metforminmetformin-associated lactic acidosismortalityorgan dysfunctionsepsissystematic review

Identifiers

PMID32166255

DOI10.1097/CCE.0000000000000009

PMCPMC7063877

OpenAlexW2938502599

What Socratic holds

Textmetadata

LicenceCC BY-NC-ND

Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.