Journal of anesthesia · 2025
Metformin's impact on delirium in diabetic cardio surgery patients.
СтатьяНазвание и аннотация: Перевод в очереди
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Lu Zhongyuan, Sun Mingyang, Chen Wan-Ming, Lv Shuang, Fu Ningning, Yang Yitian, Wang Yangyang, Miao Mengrong, Wu Szu-Yuan, Zhang Jiaqiang
Аннотация
PURPOSE: The effect of metformin on postoperative delirium (POD) in patients with type 2 diabetes mellitus (T2DM) undergoing cardiovascular surgery remains unclear. This study aimed to evaluate whether metformin use reduces POD risk in this high-risk population by analyzing data from Taiwan's National Health Insurance Research Database using propensity score matching (PSM).
METHODS: We included T2DM patients who underwent coronary artery bypass grafting (CABG) or valve replacement between 2015 and 2018. PSM was used to balance covariates between metformin users and non-users. Logistic regression and Kaplan-Meier analyses were performed to assess POD risk and its cumulative incidence.
RESULTS: Metformin use was associated with a significantly reduced risk of POD (adjusted odds ratio [aOR], 0.52; 95% confidence interval [CI], 0.40-0.67). A dose-response trend was observed, with decreasing aORs for higher cumulative metformin exposure. Protective factors included higher income, urban residency, and statin use; risk factors included older age, prolonged anesthesia, higher aDCSI, CCI scores, and depression.
CONCLUSION: Metformin significantly lowers the risk of POD in T2DM patients undergoing cardiovascular surgery, showing a clear dose-dependent protective effect. These findings highlight metformin's potential as a chemopreventive agent against post-surgical complications in this population.
METHODS: We included T2DM patients who underwent coronary artery bypass grafting (CABG) or valve replacement between 2015 and 2018. PSM was used to balance covariates between metformin users and non-users. Logistic regression and Kaplan-Meier analyses were performed to assess POD risk and its cumulative incidence.
RESULTS: Metformin use was associated with a significantly reduced risk of POD (adjusted odds ratio [aOR], 0.52; 95% confidence interval [CI], 0.40-0.67). A dose-response trend was observed, with decreasing aORs for higher cumulative metformin exposure. Protective factors included higher income, urban residency, and statin use; risk factors included older age, prolonged anesthesia, higher aDCSI, CCI scores, and depression.
CONCLUSION: Metformin significantly lowers the risk of POD in T2DM patients undergoing cardiovascular surgery, showing a clear dose-dependent protective effect. These findings highlight metformin's potential as a chemopreventive agent against post-surgical complications in this population.