Abstract

Objective: Patients undergoing intensive care commonly suffer from diabetes mellitus combined with chronic heart failure (CHF). In these patients, the use of metformin under intensive care is controversial. This study aimed to assess the mortality rates of patients with DM and CHF who are treated with metformin.

Methods: The Medical Information Mart for Intensive Care database was used to identify the patients with type 2 diabetes mellitus (T2DM) and CHF. A 90-day mortality comparison was conducted between the patients who administered metformin and those who did not. Propensity score analysis and multivariable Cox proportional hazards regression were used to ensure the robustness of our results.

Results: A total of 2,153 (180 metformin users and 1,973 non-metformin users) patients with T2DM and CHF were included in the study. The 90-day mortality rates were 30.5% (601/1,971) and 5.5% (10/182) for non-metformin and metformin users, respectively. In the propensity score matching analyses, metformin use was associated with a 71% lower 90-day mortality (hazard ratio, 0.29; 95% confidence interval, 0.14–0.59; p <0.001). The results were insensitive to change when sensitivity analyses were performed.

Conclusion: Metformin treatment may reduce the risk-related mortality in critically ill patients with T2DM and CHF in the intensive care unit.