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

医学 倾向得分匹配 围手术期 回顾性队列研究 需要治疗的数量 内科学 药方 伤口裂开 外科 2型糖尿病 裂开 糖尿病 相对风险 置信区间 内分泌学 药理学
作者
Seth Z. Aschen,Ashley Zhang,Gillian M. O’Connell,Sophia Salingaros,Caroline Andy,Christine H. Rohde,Jason A. Spector
出处
期刊:Annals of Surgery [Lippincott Williams & Wilkins]
被引量:1
标识
DOI:10.1097/sla.0000000000006614
摘要

Objective: To assess rates of surgical complications and postoperative readmission in diabetic patients with and without active perioperative prescriptions for GLP-1 RA medications. Background: With the rapid growth of glucagon-like peptide-1 receptor agonist (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 healthcare system between February 2020 to 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. 35,020 procedures in 13,129 patients (48.0% men, 52.0% women; median [IQR] age, 67 [57, 75]) were propensity score matched. After matching, the active GLP-1 RA prescription group had a significantly reduced risk of 30-day readmission (RR, 0.883; 95% CI, 0.789-0.987; P =0.028; 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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