https://scholars.lib.ntu.edu.tw/handle/123456789/596980
標題: | Outcomes after surgery in patients with diabetes who used metformin: A retrospective cohort study based on a real-world database | 作者: | Lin C.-S. Chang C.-C. Yeh C.-C. YI-CHENG CHANG Chen T.-L. Liao C.-C. |
關鍵字: | adult diabetes; metformin; mortality; surgery | 公開日期: | 2020 | 出版社: | BMJ Publishing Group | 卷: | 8 | 期: | 2 | 來源出版物: | BMJ Open Diabetes Research and Care | 摘要: | Introduction Limited information was available regarding the perioperative outcomes in patients with and without use of metformin. This study aims to evaluate the complications and mortality after major surgery in patients with diabetes who use metformin. Research design and methods Using a real-world database of Taiwan's National Health Insurance from 2008 to 2013, we conducted a matched cohort study of 91 356 patients with diabetes aged >20 years who used metformin and later underwent major surgery. Using a propensity score-matching technique adjusted for sociodemographic characteristics, medical condition, surgery type, and anesthesia type, 91 356 controls who underwent surgery but did not use metformin were selected. Logistic regression was used to calculate the ORs with 95% CIs for postoperative complications and 30-day mortality associated with metformin use. Results Patients who used metformin had a lower risk of postoperative septicemia (OR 0.94, 95% CI 0.90 to 0.98), acute renal failure (OR 0.87, 95% CI 0.79 to 0.96), and 30-day mortality (OR 0.79, 95% CI 0.71 to 0.88) compared with patients who did not use metformin, in both sexes and in every age group. Metformin users who underwent surgery also had a decreased risk of postoperative intensive care unit admission (OR 0.60, 95% CI 0.59 to 0.62) and lower medical expenditures (p<0.0001) than non-use controls. Conclusions Among patients with diabetes, those who used metformin and underwent major surgery had a lower risk of complications and mortality compared with non-users. Further randomized clinical trials are needed to show direct evidence of how metformin improves perioperative outcomes. ? 2020 Author(s). |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85097037248&doi=10.1136%2fbmjdrc-2020-001351&partnerID=40&md5=224c573bc1fe1e75c5e0113f4731b9f5 https://scholars.lib.ntu.edu.tw/handle/123456789/596980 |
ISSN: | 2052-4897 | DOI: | 10.1136/bmjdrc-2020-001351 | SDG/關鍵字: | metformin; acute heart infarction; acute kidney failure; adult; aged; Article; case control study; cerebrovascular accident; cohort analysis; controlled study; diabetes mellitus; female; hospital readmission; hospitalization; human; ICD-9; intensive care unit; length of stay; lung embolism; major clinical study; major surgery; male; middle aged; mortality; pneumonia; postoperative hemorrhage; priority journal; propensity score; retrospective study; septicemia; Taiwan; urinary tract infection; very elderly; wound infection |
顯示於: | 基因體暨蛋白體醫學研究所 |
在 IR 系統中的文件,除了特別指名其著作權條款之外,均受到著作權保護,並且保留所有的權利。