1-year patient-reported outcomes in patients with a documented GLP-1 agonist prescription history prior to total hip arthroplasty: a retrospective cohort study.

Abstract

Glucagon-like peptide-1 (GLP-1) receptor agonists are increasingly utilised for metabolic optimisation in surgical patients. Their effect on postoperative patient-reported outcomes (PROMs) and satisfaction following primary total hip arthroplasty (THA) has not been well established. This study aimed to describe the association between GLP-1 prescription history and: (1) 1-year postoperative PROMs; (2) 1-year patient satisfaction; and (3) complication rates. This is a retrospective study of 12,749 patients who underwent primary unliteral THA at a tertiary medical centre from January 2016 to December 2022. GLP-1 agonist use was defined as a documented prescription history of a GLP-1 agonist within 1-year prior to surgery (<i>n</i> = 145). Multivariable logistic regression was used to evaluate GLP-1 use and 1-year PROMs [Hip disability and Osteoarthritis Outcome Score (HOOS) Pain, Physical function Shortform (PS), and Joint Replacement (JR)]. Clinical improvements were determined by the patient acceptable symptom state (PASS) and minimal clinically importance difference (MCID) thresholds. We also used multivariable logistic regression to assess the independent association between GLP-1 use and postoperative complications. No significant difference was observed between patients with a prescription history for a GLP-1 agonist and failure to achieve PASS, MCID, or satisfaction at 1-year (odds ratio [OR] 0.99, 95% confidence interval [CI], 0.51-1.9; <i>p</i> = 0.98). However, there was reduced odds of 90-day readmission in patients with a prescription history for a GLP-1 agonist (OR = 0.47, <i>p</i> = 0.043) and an increased rate of 90-day medical complications (9.66% vs. 6.01%, <i>p</i> = 0.001). No significant differences were found for length-of-stay, 90-day emergency visits, or 2-year implant complication rates. This observational study found that patients with GLP-1 agonist prescription history experienced an increased rate of medical complications but a reduced rate of 90-day hospital readmission. Conversely, the negative findings of the study should be interpreted cautiously as the small, exposed cohort limits statistical power.