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Updated: Jan 14, 2026
Surgical Approach and Complications of Stand-alone Lateral Trans-Psoas Interbody Fusion
Published on: February 14, 2025
Association Between Preoperative GLP-1 Receptor Analog Use and Postoperative Complications and Mortality Following
Ahad A Kesaria1, Farhad A Marzook1, James M Glover2
1John Sealy School of Medicine, The University of Texas Medical Branch, Galveston, TX, USA.
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Study DesignRetrospective Cohort Study.ObjectivesThis 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.MethodsTriNetX 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.Results4331 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.ConclusionsPreoperative 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.
