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Observational Study
. 2025 Apr 1;281(4):600-607.
doi: 10.1097/SLA.0000000000006614. Epub 2024 Dec 20.

Association of Perioperative Glucagon-like Peptide-1 Receptor Agonist Use and Postoperative Outcomes

Seth Z Aschen  1 , Ashley Zhang  2 , Gillian M O'Connell  2 , Sophia Salingaros  1 , Caroline Andy  3 , Christine H Rohde  2 , Jason A Spector  1
Affiliations
Observational Study

Association of Perioperative Glucagon-like Peptide-1 Receptor Agonist Use and Postoperative Outcomes

Seth Z Aschen et al. Ann Surg. .

Abstract

Objective: To assess rates of surgical complications and postoperative readmission in diabetic patients with and without active perioperative prescriptions for glucagon-like peptide-1 receptor agonist (GLP-1 RA) medications.

Background: With the rapid growth of GLP-1 RA use in the United States, it is important to understand the potential effect of these drugs on surgical outcomes broadly.

Methods: In this retrospective, observational cohort analysis, patients with a diagnosis of type 1 or type 2 diabetes undergoing a surgical procedure at a multicenter quaternary-care health care system between February 2020 and July 2023 were included. Propensity score matching was performed between procedures in patients with and without an active GLP-1 RA prescription. The primary outcome was 30-day readmission, and secondary outcomes were documented dehiscence, infection, hematoma, and bleeding within 180 days after surgery.

Results: Among 74,425 surgical procedures in 21,772 patients included in the analysis, 27.2% were performed in the setting of an active GLP-1 RA prescription. In 13,129 patients [48.0% men, 52.0% women; median (interquartile range) age, 67 (57, 75)], 35,020 procedures were propensity score matched. After matching, the active GLP-1 RA prescription group had a significantly reduced risk of 30-day readmission [relative risk (RR): 0.883; 95% CI: 0.789-0.987; P = 0.028; number needed to treat (NNT): 219; 95% CI: 191-257], postoperative wound dehiscence (RR: 0.711; 95% CI: 0.577-0.877; P = 0.001; NNT: 266; 95% CI: 202-391), and postoperative hematoma (RR: 0.440; 95% CI: 0.216-0.894; P = 0.023; NNT: 1786; 95% CI: 652-2416). No significant differences were seen in rates of infection and bleeding.

Conclusions: An active perioperative GLP-1 RA prescription in patients with diabetes was associated with significant reductions in risk-adjusted readmission, wound dehiscence, and hematoma, and no difference in infection and bleeding rates. Further study is warranted to elucidate any causal association.

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Conflict of interest statement

The authors report no conflicts of interest.

Figures

Figure 1:
Figure 1:
Flow diagram of patients in the propensity score-matched cohorts a Exclusion criteria were not mutually exclusive
See this image and copyright information in PMC

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