PREOPERATIVE USE OF GLUCAGON-LIKE PEPTIDE-1 RECEPTOR AGONISTS (GLP-1 RAS)AND SHORT-TERM POSTOPERATIVE OUTCOMES AFTER BARIATRIC SURGERY: A RETROSPECTIVE COHORT STUDY
Author(s)
Yumeng Wang, MBBS1, Jung-Im Shin, MD, PHD1, Minji Kim, PharmD, ScM1, Michael Schweitzer, MD2, G. Caleb Alexander, MD, MS1, Hemalkumar Mehta, MS, PhD1;
1Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA, 2Johns Hopkins School of Medicine, Baltimore, MD, USA
1Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA, 2Johns Hopkins School of Medicine, Baltimore, MD, USA
OBJECTIVES: To compare 30-day postoperative outcomes among glucagon-like peptide-1 receptor agonists (GLP-1 RAs) users and non-users after bariatric surgery.
METHODS: We performed a retrospective cohort study among adults who underwent bariatric surgery between 2016 and 2024 using data from TriNetX, a large, multi-institutional U.S. electronic health record network. We defined preoperative GLP-1 RAs use as any prescription containing semaglutide, liraglutide, tirzepatide, dulaglutide within 6 months before the surgery. Quantified outcomes included postoperative complications (surgical, thromboembolic, cardiovascular, pulmonary, infectious, neurologic, renal, and hemodynamic), emergency department visits, and any reoperations or revisions. We performed 1:1 propensity score matching to balance baseline demographics, presurgical body mass index and comorbidities between GLP-1 RAs users and non-users and used logistic regression with robust standard errors to estimate odds ratios (ORs) and 95% confidence intervals (CI).
RESULTS: Among 136,530 patients who underwent bariatric surgery, 8,264 (6.05%) used GLP-1 RAs within 6 months of surgery. Individuals who used GLP-1 RAs were older, had greater BMI, and higher comorbidity burden. After propensity score matching, both groups were well-balanced across observable characteristics. In the propensity score matched sample, preoperative GLP-1RAs use was associated with an overall lower risk of surgery-related complications (3.26% vs 2.54%; OR 0.77, CI 0.65-0.93), postoperative pulmonary infection (1.33% vs 0.93%; OR 0.70, CI 0.52-0.93), and sepsis (0.91% vs 0.51%; OR 0.56, CI 0.38-0.81). GLP-1 RAs use was also associated with lower odds of emergency department visits (17.5% vs 14.6%; OR 0.81, CI 0.75-0.88) and any reoperation or revisions (1.16% vs 1.50%; OR 0.77, CI 0.59-1.01).
CONCLUSIONS: Among this cohort of adults undergoing bariatric surgery in the United States, preoperative GLP-1 RAs use was associated with improved short-term surgical outcomes. Further work should evaluate these associations using additional methods to maximize the ability for causal inference.
METHODS: We performed a retrospective cohort study among adults who underwent bariatric surgery between 2016 and 2024 using data from TriNetX, a large, multi-institutional U.S. electronic health record network. We defined preoperative GLP-1 RAs use as any prescription containing semaglutide, liraglutide, tirzepatide, dulaglutide within 6 months before the surgery. Quantified outcomes included postoperative complications (surgical, thromboembolic, cardiovascular, pulmonary, infectious, neurologic, renal, and hemodynamic), emergency department visits, and any reoperations or revisions. We performed 1:1 propensity score matching to balance baseline demographics, presurgical body mass index and comorbidities between GLP-1 RAs users and non-users and used logistic regression with robust standard errors to estimate odds ratios (ORs) and 95% confidence intervals (CI).
RESULTS: Among 136,530 patients who underwent bariatric surgery, 8,264 (6.05%) used GLP-1 RAs within 6 months of surgery. Individuals who used GLP-1 RAs were older, had greater BMI, and higher comorbidity burden. After propensity score matching, both groups were well-balanced across observable characteristics. In the propensity score matched sample, preoperative GLP-1RAs use was associated with an overall lower risk of surgery-related complications (3.26% vs 2.54%; OR 0.77, CI 0.65-0.93), postoperative pulmonary infection (1.33% vs 0.93%; OR 0.70, CI 0.52-0.93), and sepsis (0.91% vs 0.51%; OR 0.56, CI 0.38-0.81). GLP-1 RAs use was also associated with lower odds of emergency department visits (17.5% vs 14.6%; OR 0.81, CI 0.75-0.88) and any reoperation or revisions (1.16% vs 1.50%; OR 0.77, CI 0.59-1.01).
CONCLUSIONS: Among this cohort of adults undergoing bariatric surgery in the United States, preoperative GLP-1 RAs use was associated with improved short-term surgical outcomes. Further work should evaluate these associations using additional methods to maximize the ability for causal inference.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EPH123
Topic
Epidemiology & Public Health
Topic Subcategory
Safety & Pharmacoepidemiology
Disease
SDC: Diabetes/Endocrine/Metabolic Disorders (including obesity), SDC: Gastrointestinal Disorders, STA: Surgery