Preoperative metformin tied to better surgical outcomes

Preoperative metformin tied to better surgical outcomes

(HealthDay)—Preoperative metformin prescriptions may be associated with decreased postoperative mortality and readmission among patients with diabetes undergoing a major surgical procedure, according to a study published online April 8 in JAMA Surgery.

Katherine M. Reitz, M.D., from the University of Pittsburgh School of Medicine, and colleagues used electronic health record data to identify 10,088 adults with diabetes who underwent a major operation with hospital admission (January 2010 to January 2016) at 15 community and academic hospitals within one health care system. Fifty-nine percent had preoperative metformin prescriptions. The analysis included 5,460 propensity score-matched patients (mean age, 67.7 years; 53 percent women).

The researchers found that in the -matched cohort, preoperative metformin was associated with a reduced hazard for 90-day mortality (adjusted hazard ratio [HR], 0.72 [95 percent confidence interval (CI), 0.55 to 0.95]; absolute risk reduction [ARR], 1.28 percent [95 percent CI, 0.26 to 2.31]) and hazard of readmission at 30 days (ARR, 2.09 percent [95 percent CI, 0.35 to 3.82]; sub-HR, 0.84 [95 percent CI, 0.72 to 0.98]) and 90 days (ARR, 2.78 percent [95 percent CI, 0.62 to 4.95]; sub-HR, 0.86 [95 percent CI, 0.77 to 0.97]). Preoperative inflammation was lower in those with prescriptions versus those without (mean neutrophil-to-leukocyte ratio, 4.5 [95 percent CI, 4.3 to 4.6] versus 5.0 [95 percent CI, 4.8 to 5.3]).

"The advantages are likely not disease specific, but instead the pleiotropic properties may modulate the generated by a major surgical intervention or confer consistently good outcomes, regardless of the ," the authors write.

Two authors disclosed financial ties to the pharmaceutical industry.

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Journal information: JAMA Surgery

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