TY - JOUR
T1 - Glucagon-like peptide-1 receptor agonist use is associated with increased risk of perioperative complication and readmission following shoulder arthroplasty
AU - Lawand, Jad J.
AU - Tansey, Patrick J.
AU - Ghali, Abdullah
AU - Tye, Cooper
AU - Hantouly, Ashraf
AU - Fares, Mohamad Y.
AU - Khan, Adam Z.
AU - Somerson, Jeremy S.
AU - Abboud, Joseph A.
N1 - Publisher Copyright:
© 2024 Journal of Shoulder and Elbow Surgery Board of Trustees
PY - 2025
Y1 - 2025
N2 - Background: Glucagon-like peptide-1 (GLP-1) receptor agonists, increasingly used for diabetes management and weight loss, have been linked to lower readmission rates after knee and hip arthroplasty. However, their impact on total shoulder arthroplasty (TSA) outcomes remains unclear. This study investigates the effects of GLP-1 receptor agonists on major complications and revisions following TSA. Methods: A retrospective query of the TriNetX database from 2010 to 2023 was performed to identify patients who underwent anatomic or reverse TSA and were prescribed GLP-1 receptor agonists. GLP-1 receptor agonist users were 1:1 propensity score-matched to controls for demographic factors and comorbidities, yielding 1259 patients in each group. Outcomes included 90-day postoperative medical complications and readmission and revision surgery at 2 years. Odds ratios (ORs), 95% confidence intervals, and P values were calculated. After Bonferroni correction, P <.005 was considered significant. Results: GLP-1 receptor agonist users (n = 1259) experienced significantly higher rates of deep vein thrombosis (1.6% vs. 0.9%; OR 3.0; P =.001), myocardial infarction (1.60% vs. 0.9%; OR 2.84; P =.003), pneumonia (3.34% vs. 1.50%; OR 2.25; P =.003), transfusion (7.1% vs. 4.3%; OR 1.7; P =.003), and readmission (8.1% vs. 5.2%; OR 1.6; P =.004) in the 90-day postoperative period compared to patients not taking GLP-1 receptor agonists. There were no differences in the rates of stroke, pulmonary embolism, postoperative anemia, or renal failure. In patients with a minimum 2-year follow-up (n = 776), there was no difference in revision rate (3.2% vs. 1.8%; OR 1.8; P =.07). Conclusion: GLP-1 receptor agonist use during TSA was associated with an increased risk of deep vein thrombosis, myocardial infarction, pneumonia, need for transfusion, and readmission. Further investigation into the perioperative risk assessment and medical optimization of patients utilizing GLP-1 receptor agonists may be warranted.
AB - Background: Glucagon-like peptide-1 (GLP-1) receptor agonists, increasingly used for diabetes management and weight loss, have been linked to lower readmission rates after knee and hip arthroplasty. However, their impact on total shoulder arthroplasty (TSA) outcomes remains unclear. This study investigates the effects of GLP-1 receptor agonists on major complications and revisions following TSA. Methods: A retrospective query of the TriNetX database from 2010 to 2023 was performed to identify patients who underwent anatomic or reverse TSA and were prescribed GLP-1 receptor agonists. GLP-1 receptor agonist users were 1:1 propensity score-matched to controls for demographic factors and comorbidities, yielding 1259 patients in each group. Outcomes included 90-day postoperative medical complications and readmission and revision surgery at 2 years. Odds ratios (ORs), 95% confidence intervals, and P values were calculated. After Bonferroni correction, P <.005 was considered significant. Results: GLP-1 receptor agonist users (n = 1259) experienced significantly higher rates of deep vein thrombosis (1.6% vs. 0.9%; OR 3.0; P =.001), myocardial infarction (1.60% vs. 0.9%; OR 2.84; P =.003), pneumonia (3.34% vs. 1.50%; OR 2.25; P =.003), transfusion (7.1% vs. 4.3%; OR 1.7; P =.003), and readmission (8.1% vs. 5.2%; OR 1.6; P =.004) in the 90-day postoperative period compared to patients not taking GLP-1 receptor agonists. There were no differences in the rates of stroke, pulmonary embolism, postoperative anemia, or renal failure. In patients with a minimum 2-year follow-up (n = 776), there was no difference in revision rate (3.2% vs. 1.8%; OR 1.8; P =.07). Conclusion: GLP-1 receptor agonist use during TSA was associated with an increased risk of deep vein thrombosis, myocardial infarction, pneumonia, need for transfusion, and readmission. Further investigation into the perioperative risk assessment and medical optimization of patients utilizing GLP-1 receptor agonists may be warranted.
KW - Diabetes mellitus
KW - glucagon-like peptide 1
KW - glucagon-like peptide 1 receptor agonists
KW - Level III
KW - postoperative complications
KW - Prognosis Study
KW - Retrospective Cohort Comparison Using Large Database
KW - risk assessment
KW - shoulder replacement arthroplasty
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U2 - 10.1016/j.jse.2024.09.012
DO - 10.1016/j.jse.2024.09.012
M3 - Article
C2 - 39528042
AN - SCOPUS:85214197155
SN - 1058-2746
JO - Journal of Shoulder and Elbow Surgery
JF - Journal of Shoulder and Elbow Surgery
ER -