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

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.