What question did this study set out to answer?

To explore the relationship between prior GLP-1 usage and outcomes in septic patients with obesity.

March 26, 2026Critical Care Medicine0 citations

848: Prior GLP-1 Usage May Be Associated With Reduced Mortality in Septic Surgical Patients With Obesity

JKJasmine Kelley LSLindsay O. Stepp HBHolly Baselice

Key Points

To explore the relationship between prior GLP-1 usage and outcomes in septic patients with obesity.
Review of 1,386 surgical patients with sepsis over eight years
Grouping of patients based on obesity and GLP-1 usage
Comparison of demographic data, comorbidities, and sepsis presentation
Assessment of 90-day mortality and survival rates
OB/GLP patients had the lowest in-hospital mortality at 13.3%
Cumulative 90-day mortality was 20.0% in OB/GLP versus 35% in OB group
OB/GLP had higher incidence of soft tissue infections at 36.4%
No significant differences in comorbidity index, age, or SOFA scores across cohorts

Abstract

Introduction: Recent data suggests that GLP-1 agonists have anti-inflammatory effects that may reduce immune dysregulation in sepsis. We have previously shown that septic surgical patients with obesity exhibit higher 90-day mortality compared to non-obese cohorts. The objective of this abstract was to characterize the association between pre-admission GLP-1 usage and sepsis outcomes in septic patients with obesity. Methods: We reviewed all surgical patients with sepsis (SOFA ≥2) at a single institution (n=1386, 2011-2019). Patients were grouped into obese with prior GLP1 usage (OB/GLP, n=15), obese (BMI≥30 kg/m2) without GLP1 (OB, n=748), non-obese without GLP1 (BMI:18.5-29.9kg/m2) (NOB, n=613), and NOB with GLP1 (NOB/GLP, n=10). Demographic data, comorbidities, and sepsis presentation were compared. The primary outcome was cumulative 90-day mortality and survival. A p< 0.05 was significant. Results: There was no difference in Charlson comorbidity index, age, or admission SOFA scores between all four cohorts. There was no difference in BMI between both obese cohorts. The median months spent on a GLP1 agonist prior to admission was 9.2 (1.4-32.8). Compared to the remaining cohorts, OB/GLP patients presented with more soft tissue infections (36.4% vs 0-18.5%, p = 0.015) and had a higher prevalence of type 2 diabetes (p < 0.0005). OB/GLP patients had the lowest in-hospital mortality (13.3%) compared to OB (29%), NOB (17.1%), and NOB/GLP patients (20.0%) (p < 0.005). Cumulative 90-day mortality was similarly lower in the OB/GLP cohort (20.0%) compared to OB (35%) and NOB (26.3%) cohorts (p = 0.02). Unadjusted 90-day survival was higher in both GLP cohorts compared to the NOB and OB control cohorts (logrank p < 0.005). Conclusions: This is a preliminary study limited by a small sample size. Despite the lack of power, these data suggest a possible association between GLP1 usage and sepsis outcomes. This study will provide a platform for upcoming robust analyses to investigate this interaction, specifically evaluating how GLP1 usage may modulate physiologic reserve and sepsis presentation.

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