Key result
Preoperative GLP-1 RA use linked to ~54% lower 1-year mortality after lumbar fusion.
Why the study?
The association between preoperative GLP-1 receptor analog use and postoperative outcomes in patients undergoing lumbar fusion surgery was unclear.
Does preoperative GLP-1 RA use reduce postoperative complications and mortality in patients undergoing lumbar fusion surgery?
Cohort (n=8,662)
Yes
Does preoperative GLP-1 RA use reduce postoperative complications and mortality in patients undergoing lumbar fusion surgery?
Preoperative GLP-1 RA use in patients undergoing lumbar fusion surgery is associated with a significantly reduced risk of 1-year postoperative medical and surgical complications, including a reduction in all-cause mortality and venous thromboembolism.
May warrant preoperative GLP-1 RA consideration in lumbar fusion; leaves open causation versus confounding and needs randomized trials.
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.
No takes yet. Share an insight, caveat, or question.
Kesaria et al. (2025) conducted a cohort in Patients undergoing lumbar fusion surgery (n=8,662). Preoperative GLP-1 receptor analog (GLP-1 RA) use vs. No preoperative GLP-1 RA use was evaluated on All-cause mortality at 1 year (RR 0.46, 95% CI 0.36-0.589, p=<0.0001). Preoperative use of GLP-1 receptor analogs before lumbar fusion surgery was associated with significantly lower 1-year rates of all-cause mortality (RR 0.46) and pseudoarthrosis (RR 0.64) compared to matched non-users.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: