The pooled results demonstrated a robust and highly significant survival benefit in patients diagnosed under Sepsis-3 criteria (OR, 0.47; 95% CI, 0.39–0.57, P < 0.00001) ( Figure 6A ) and Sepsis-1/2 (OR, 0.61; 95% CI, 0.41–0.90, P = 0.0008) ( Figure 6C ).
However, in the subgroup utilizing Sepsis-2 criteria, the protective effect of metformin was attenuated and did not reach statistical significance (OR, 0.80; 95% CI, 0.52–1.21, P = 0.29) ( Figure 6B ). analyse Sensitivity s Given that all included studies were observational cohorts with minimal risk of bias ( Supplementary Table 4 ), no sensitivity analysis was carried out based on methodological criteria.