Some questions about preadmission metformin use and mortality in patients with sepsis and diabetes mellitus

[4] indicated that while diabetes mellitus seems to be a protective factor in sepsis patients, hyper- or hypoglycemia status on admission, and increased blood glucose variation during hospital stays, was independently associated with increased odds ratio of mortality. [...]it did not seem persuasive that metformin use could completely predict outcomes without adjusting for the covariate of diabetes. [...]the article pointed out that the heterogeneity may be derived from many causes, such as the small sample sizes, the different initial lactate levels, and the use of other antidiabetic medications. [...]differences in the Simplified Acute Physiology Score II, Acute Physiology and Chronic Health Evaluation II (APACHE) II score, and Sequential Organ Failure Assessment (SOFA) score baselines may also lead to statistical heterogeneity in the five studies included [5]. [...]it is necessary to adjust Simplified Acute Physiology Score II, APACHE II score, and SOFA score for statistical analysis in this article as these details could change the final results.