Preoperative Use of GLP-1 Receptor Agonists and Postoperative Outcomes in Patients Undergoing Arthroplasty: A Systematic Review With Exploratory Meta-analysis
Abstract
Introduction: Arthroplasty is a common procedure in older adults with multiple comorbidities. Glucagon-like peptide-1 (GLP-1) receptor agonists are used to treat diabetes mellitus and obesity. Their preoperative use may influence postoperative outcomes in patients undergoing different types of arthroplasty, although the available evidence is inconsistent. Objective: To evaluate the association between preoperative use of GLP-1 receptor agonists and postoperative complications in patients undergoing arthroplasty. Materials and Methods: A systematic review was conducted in accordance with the PRISMA 2020 guidelines, with artificial intelligence support to optimize the search strategy for PubMed, Scopus, and Web of Science. Studies of patients undergoing hip, knee, or shoulder arthroplasty who had received GLP-1 receptor agonists preoperatively were included if they reported data on postoperative complications and hospital readmission within 90 days. An exploratory meta-analysis was performed using a random-effects model, with results expressed as odds ratios (ORs), 95% confidence intervals (CIs), and p-values. Heterogeneity was assessed using the I² statistic. Results: Four observational studies were analyzed. Preoperative use of GLP-1 receptor agonists was associated with lower odds of surgical site infection (OR, 0.48; 95% CI, 0.35–0.66; p < 0.001; I² = 0%). The analysis of hospital readmission showed high heterogeneity (I² = 86%). Conclusions: Preoperative use of GLP-1 receptor agonists was associated with lower odds of postoperative infection in patients undergoing arthroplasty. However, given the small number of observational studies and the heterogeneity among arthroplasty types, these findings should be interpreted with caution and considered hypothesis-generating.Downloads
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