在使用GLP-1受体激活剂的成年人中,术后吸气性肺炎
Yuan-Hsin Chen1,2, Thomas Zink3,4, Ya-Wen Chen1,2
1Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston.
JAMA network open
|March 4, 2025
概括
在常见的手术中,手术前使用葡萄糖类-1受体激活剂 (GLP-1RA) 并没有增加术后吸气性肺炎的风险. 这一发现可能会影响在程序之前保留GLP-1RA的指导方针.
科学领域:
- 麻醉学 麻醉学
- 药理学 药理学是指药理学的学科.
- 胃肠病学 胃肠病学
背景情况:
- 葡萄糖类-1受体激动剂 (GLP-1RA) 越来越多地用于体重管理.
- 人们对与手术前GLP-1RA使用相关的潜在手术并发症存在担忧.
- 有限的数据可用于术前GLP-1RA使用和术后结果之间的关联.
研究的目的:
- 确定手术前GLP-1RA的使用是否与常见外科手术后更高的吸入性肺炎风险有关.
- 在选择性手术之前调查持续GLP-1RA的安全性.
主要方法:
- 使用MarketScan商业索赔数据库进行回顾性队列研究 (2020年4月 - 2022年9月).
- 包括接受14种常见外科手术中的1种手术的患者,但不包括患有特定并发症或先前有呼吸系统问题的患者.
- 分析了366,476名患者,比较了GLP-1RA用户和非用户之间的结果,并对共变量进行了调整.
主要成果:
- 1.6%的患者 (5,931) 接受了手术前的GLP-1 RA处方.
- GLP-1 RA使用者更有可能是女性,患有肥胖和糖尿病.
- 在GLP-1RA使用者和非使用者之间没有观察到30天术后吸入性肺炎的几率有显著差异 (OR,0.78;95% CI,0.57-1.06).
结论:
- 在手术前使用GLP-1RA并没有显著增加短期术后吸入性肺炎的风险.
- 目前的发现表明,GLP-1RA的手术前扣留指南可能需要重新评估.
- 这项研究有助于了解GLP-1RA的外科安全性.
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