Metformin administration improves adverse outcomes in older adult burn patients: a single-centre cohort study.

This study assesses the safety and efficacy of metformin administration in older adult burn patients, a rapidly growing demographic with substantially poorer outcomes. This is a single-centre cohort study of older adults (≥60 years) admitted to a provincial burn center over 15 years. Clinical outcomes, laboratory measures, inflammatory markers, and adipose tissue single-nuclei RNA sequencing (SnRNA-seq) were compared among metformin-treated and non-treated controls. A total of 50 metformin-treated and 262 control older burn patients met the eligibility criteria. Despite pre-admission comorbidities, metformin-treated patients showed improved survival, no significant differences in the number of hypoglycemic episodes, a lower incidence of lactic acidosis, and reduced circulating levels of organ damage markers. SnRNA-Seq further revealed that metformin may exert its beneficial effects by local restoration of immune and inflammatory responses. In older burn patients, metformin was linked with improved outcomes and no adverse effects, underscoring its safety and efficacy in this population.