Summary
Factors associated with death due to lactic acidosis in patients with type-2 diabetes treated with metformin
Quesada Redondo L, Morell García D, Barceló Martín B, Puiguriguer Ferrando J
Affiliation of the authors
Servicio de Análisis Clínicos, Hospital Universitari Son Espases, Palma de Mallorca, Spain. Servicio de Urgencias, Hospital Universitari Son Espases, Palma de Mallorca, Spain. Unidad de Toxicología Clínica, Hospital Universitari Son Espases, Palma de Mallorca, Spain.
DOI
Quote
Quesada Redondo L, Morell García D, Barceló Martín B, Puiguriguer Ferrando J. Factors associated with death due to lactic acidosis in patients with type-2 diabetes treated with metformin. Emergencias. 2016;28:38-40
Summary
To identify analytical factors associated with mortality in patients with type-2 diabetes under long-term treatment with metformin who come to the emergency department with acute symptoms of lactic acidosis. Retrospective observational analysis of patient records in a referral hospital. We collected clinical data and laboratory results for a series of
metformin-treated patients with type-2 diabetes who developed lactic acidosis, stratified by severity. Factors related to the episode were analyzed for associations with mortality or survival. Of 16 patients studied (mean age 70 years; range, 60-77 years), 75% had gastrointestinal symptoms in the 5 days before they came to the emergency department.
Mortality (19%) was associated with sepsis on arrival; elevated white blood cell counts, particularly neutrophil counts; low platelet counts; high C-reactive protein (CRP) and procalcitonin levels; and 1 or more chronic concomitant diseases.Metformin concentration was not significantly associated with mortality. Signs of sepsis, high neutrophil counts
with low platelet counts, elevated CRP and procalcitonin levels, and the presence of 1 or more concomitant diseases may be risk factors for death in metformin-treated patients with lactic acidosis.