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GLP-1 Receptor Agonist Use in Patients Undergoing Distal Radius Fracture Surgery: A Retrospective Review of Perioperative Considerations
Mohammad Khak, MD, MPH
1, Jeremiah A. Adams, BS
1,2, Muhammad Hozien, BS
3, Anthony Castro, BA
1, Chris Sun, BA
1; Asif M. Ilyas, MD, MBA
1,2,3(1)Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA, (2)Sidney Kimmel Medical College, Philadelphia, PA, (3)Drexel University College of Medicine, Philadelphia, PA
Background: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are increasingly prescribed for glycemic control and weight loss, but their effects on surgical outcomes remain incompletely understood. Delayed gastric emptying and associated perioperative risks have prompted updated anesthetic guidelines, though evidence in orthopedic or hand surgery remains limited. This study aims to evaluate the prevalence of GLP-1 RA use and its perioperative implications among patients undergoing surgical fixation for distal radius fractures (DRFs).
Methods: A retrospective review of 4,811 adult patients undergoing operative treatment for DRFs between 2019 and 2024 was conducted. GLP-1 RA use prior to surgery was identified through medication reconciliation. Demographics, comorbidities, medication type, and postoperative complications, including nausea, vomiting, abdominal pain, aspiration, emergency visits, and hospital readmissions, were assessed.
Results: GLP-1 RA use was observed in 46 patients (1.0%) over the 6-year period, with prevalence rising to 2.9% in 2024. Semaglutide was the most commonly used agent. GLP-1 users had significantly higher BMI and higher rates of type 2 diabetes, hypertension, and cardiovascular disease compared to non-users. Only one GLP-1 user (2.2%) experienced postoperative nausea; no cases of readmission, aspiration, or serious complications were documented.
Conclusion: GLP-1 RA use among patients is increasing, reflecting broader prescribing trends. In this cohort, perioperative complications were rare, though underreporting may be a factor. Surgeons should be aware of potential anesthetic considerations, evolving guidelines, and the need for coordinated perioperative planning as GLP-1 use expands.
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