TY - JOUR
T1 - Association Between Preoperative GLP-1 Receptor Analog Use and Postoperative Complications and Mortality Following Lumbar Fusion Surgery
AU - Kesaria, Ahad A.
AU - Marzook, Farhad A.
AU - Glover, James M.
AU - Alijanipour, Pouya
N1 - Publisher Copyright:
© The Author(s) 2025. This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
PY - 2025
Y1 - 2025
N2 - Study Design: Retrospective Cohort Study. Objectives: This study evaluates the association between preoperative GLP-1 RA (glucagon-like-peptide-1 receptor antagonist) use and postoperative outcomes in patients undergoing lumbar fusion surgery. Methods: TriNetX database identified patients undergoing lumbar fusion within 20 years using Current Procedural Terminology (CPT). Patients were categorized by GLP-1 RA use within 1 year preoperatively. 1:1 propensity score match (PSM) balanced demographics and comorbidities including race/ethnicity, age, gender, hypertension, diabetes, obesity, nicotine dependence, sleep apnea, ischemic heart diseases, chronic kidney disease, acute kidney failure, mood disorders, asthma, chronic obstructive pulmonary disease, heart failure, alcohol dependence, anemia, and vitamin D deficiency. Primary outcomes were 1-year complications postoperatively. Chi-square analysis, risk ratios (RRs), 95% confidence intervals (CI), and P-values were calculated; significance was P < 0.05. Results: 4331 patients using preoperative GLP-1 RA were propensity score-matched with 179,268 controls without GLP-1 RA use, resulting in 4331 patients in each cohort after matching. At 1 year, GLP-1 RA users had significant reductions in DVT (1.4% vs 2.3%, RR = 0.64, 95% CI [0.464-0.883], P = 0.0061), PE (1.1% vs 1.6%, RR = 0.689, 95% CI [0.476-0.997], P = 0.0466), sepsis (4.0% vs 5.0%, RR = 0.811, 95% CI [0.66-0.995], P = 0.0447), all-cause mortality (2.1% vs 4.6%, RR = 0.46, 95% CI [0.36-0.589], P < 0.0001), pneumonia (2.4% vs 3.3%, RR = 0.716, 95% CI [0.548-0.936], P = 0.0139), and pseudoarthrosis (8.9% vs 13.8%, RR = 0.642, 95% CI [0.564-0.732], P < 0.0001) compared to non-users. Conclusions: Preoperative GLP-1 RA use is associated with a reduction in postoperative complications following lumbar fusion surgery. Further research is necessary to elucidate the underlying mechanisms and evaluate long-term outcomes.
AB - Study Design: Retrospective Cohort Study. Objectives: This study evaluates the association between preoperative GLP-1 RA (glucagon-like-peptide-1 receptor antagonist) use and postoperative outcomes in patients undergoing lumbar fusion surgery. Methods: TriNetX database identified patients undergoing lumbar fusion within 20 years using Current Procedural Terminology (CPT). Patients were categorized by GLP-1 RA use within 1 year preoperatively. 1:1 propensity score match (PSM) balanced demographics and comorbidities including race/ethnicity, age, gender, hypertension, diabetes, obesity, nicotine dependence, sleep apnea, ischemic heart diseases, chronic kidney disease, acute kidney failure, mood disorders, asthma, chronic obstructive pulmonary disease, heart failure, alcohol dependence, anemia, and vitamin D deficiency. Primary outcomes were 1-year complications postoperatively. Chi-square analysis, risk ratios (RRs), 95% confidence intervals (CI), and P-values were calculated; significance was P < 0.05. Results: 4331 patients using preoperative GLP-1 RA were propensity score-matched with 179,268 controls without GLP-1 RA use, resulting in 4331 patients in each cohort after matching. At 1 year, GLP-1 RA users had significant reductions in DVT (1.4% vs 2.3%, RR = 0.64, 95% CI [0.464-0.883], P = 0.0061), PE (1.1% vs 1.6%, RR = 0.689, 95% CI [0.476-0.997], P = 0.0466), sepsis (4.0% vs 5.0%, RR = 0.811, 95% CI [0.66-0.995], P = 0.0447), all-cause mortality (2.1% vs 4.6%, RR = 0.46, 95% CI [0.36-0.589], P < 0.0001), pneumonia (2.4% vs 3.3%, RR = 0.716, 95% CI [0.548-0.936], P = 0.0139), and pseudoarthrosis (8.9% vs 13.8%, RR = 0.642, 95% CI [0.564-0.732], P < 0.0001) compared to non-users. Conclusions: Preoperative GLP-1 RA use is associated with a reduction in postoperative complications following lumbar fusion surgery. Further research is necessary to elucidate the underlying mechanisms and evaluate long-term outcomes.
KW - GLP-1 analogs
KW - lumbar arthrodesis
KW - lumbar fusion surgery
KW - postoperative complications
KW - postoperative outcomes
UR - https://www.scopus.com/pages/publications/105019984801
UR - https://www.scopus.com/pages/publications/105019984801#tab=citedBy
U2 - 10.1177/21925682251391693
DO - 10.1177/21925682251391693
M3 - Article
C2 - 41138231
AN - SCOPUS:105019984801
SN - 2192-5682
JO - Global Spine Journal
JF - Global Spine Journal
M1 - 21925682251391693
ER -