Glucagon-like peptide-1 Agonists and Common Hand Procedures: Perioperative and Postoperative Risks and Complications.

IF 2.1 2区 医学 Q2 ORTHOPEDICS
Troy B Amen, Lina I Ibrahim, Stephen M Gillinov, Kaveh A Torabian, Michael C Dean, Adriana Liimakka, Steve K Lee
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引用次数: 0

Abstract

Purpose: Glucagon-like peptide-1 (GLP-1) receptor agonists have recently become a cornerstone in managing type 2 diabetes mellitus and obesity given their ability to improve glycemic control and promote weight loss. However, the postoperative safety profile of these medications in patients undergoing common hand procedures remains poorly studied. The purpose of this study was to evaluate the effects of preoperative GLP-1 agonists use on postoperative complications, readmission, and reoperation following several commonly performed hand procedures.

Methods: A retrospective study using a large insurance claims database was performed from 2015 to 2022. Patients undergoing six common hand procedures were queried. Individuals taking GLP-1 agonists at the time of surgery were propensity score-matched to those not taking the medications in a 1:4 fashion controlling for numerous clinical variables. Postoperative complications, 90-day readmission, 90-day reoperation for infection, and 2-year all-cause revision rates were then calculated between both groups using multivariable logistic regression.

Results: Patients taking GLP-1 agonists had equal or lower odds of postoperative infections including lower rates of surgical site infections and equal rates of wound dehiscence. These patients also had lower risk of postoperative pneumonia, acute kidney injury, hematoma, pulmonary embolism, and deep vein thrombosis. Risk of all-cause 90-day readmission was significantly lower for patients taking GLP-1 agonists. Rates of 90-day reoperation for infection and 2-year all-cause revision were equal between both cohorts.

Conclusion: This study found that patients taking GLP-1 agonists were at no higher risk for 90-day postoperative infections including surgical site infections and wound dehiscence. Furthermore, these patients demonstrated equal or lower rates of overall perioperative complications, reoperation, and readmission compared to their matched controls.

Type of study/level of evidence: Prognostic IIc.

胰高血糖素样肽-1激动剂和常用手操作:围手术期和术后风险和并发症。
目的:胰高血糖素样肽-1 (GLP-1)受体激动剂由于其改善血糖控制和促进体重减轻的能力,最近成为治疗2型糖尿病和肥胖的基石。然而,这些药物在接受普通手手术的患者术后的安全性研究仍然很少。本研究的目的是评估术前使用GLP-1激动剂对术后并发症、再入院和几种常用手手术后再手术的影响。方法:采用2015 - 2022年大型保险理赔数据库进行回顾性研究。对接受六种常见手部手术的患者进行了调查。在手术时服用GLP-1激动剂的个体与未服用药物的个体以1:4的方式匹配倾向性评分,控制了许多临床变量。采用多变量logistic回归计算两组患者术后并发症、90天再入院、90天感染再手术和2年全因翻修率。结果:服用GLP-1激动剂的患者术后感染的几率相同或更低,包括手术部位感染的几率更低,伤口裂开的几率也更低。这些患者术后肺炎、急性肾损伤、血肿、肺栓塞和深静脉血栓形成的风险也较低。服用GLP-1激动剂的患者90天全因再入院的风险显著降低。在两个队列中,90天感染再手术率和2年全因翻修率相等。结论:本研究发现,服用GLP-1激动剂的患者术后90天感染(包括手术部位感染和伤口裂开)的风险没有增加。此外,与对照组相比,这些患者表现出相同或更低的围手术期并发症、再手术和再入院率。研究类型/证据水平:预后性IIc。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
3.20
自引率
10.50%
发文量
402
审稿时长
12 weeks
期刊介绍: The Journal of Hand Surgery publishes original, peer-reviewed articles related to the pathophysiology, diagnosis, and treatment of diseases and conditions of the upper extremity; these include both clinical and basic science studies, along with case reports. Special features include Review Articles (including Current Concepts and The Hand Surgery Landscape), Reviews of Books and Media, and Letters to the Editor.
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