降低风险：与未使用这些药物的肥胖患者相比，胰高血糖素样肽-1受体激动剂疗法可能会降低髋部骨折患者的院内并发症和再入院率。
Slimming the risks: GLP-1 receptor agonist therapy may reduce in-hospital complications and hospital readmissions rates for hip fractures compared to obese patients not on these medications.
作者信息
Goldstein Amelia R, Olson Danielle, Leucht Phillip, Tejwani Nirmal, Ganta Abhishek, Konda Sanjit, Egol Kenneth A
机构信息
Department of Orthopedic Surgery, New York University Langone Medical Center, New York, USA.
出版信息
Eur J Orthop Surg Traumatol. 2025 Sep 2;35(1):377. doi: 10.1007/s00590-025-04477-0.
INTRODUCTION
To evaluate the impact of prolonged GLP-1 usage on mortality, readmission, incidence of in-hospital complications, and incidence of implant failure following hip fracture surgery across various BMI strata.
METHODS
A prospective hip fracture registry (2014-2024) at a single institution was used to identify 58 obese patients on prolonged GLP-1 therapy at the time of injury. These patients (Group A) were matched by age, fracture pattern, and comorbidity burden to BMI-based control cohorts: normal (Group B), overweight (Group C), and obese (Group D). Postoperative complication rates, readmissions, and implant failures were compared. Major complications were defined as events needing further procedures, extended hospitalization, or causing significant functional impairment. Minor complications were those managed with minimal treatment. Statistical analysis included ANOVA, chi-square, and post hoc residual testing. Data were analyzed using IBM SPSS Statistics (Version 21.0, Chicago, IL).
RESULTS
A total of 232 patients (58 in each cohort) were included. Minor complication rates differed significantly across cohorts (χ ≈ 15.25, p < 0.01): 17.24% in Group A, 37.93% in Group B, 51.72% in Group C, and 48.28% in Group D. Overall complication rates differed significantly across groups (χ ≈ 17.33, p < 0.001): 22.41% in Group A, 55.17% in Group B, 51.72% in Group C, and 60.34% in Group D. Group D exhibited significantly higher 30-day (17.24%, p < 0.001) and 90-day (24.14%, p < 0.05) readmission rates. No significant differences were observed in major complications, hardware failure incidence, or 30-day or 1-year.
CONCLUSIONS
≥ 6 months of continuous GLP-1 receptor agonist therapy was associated with a reduction in 30-day and 90-day readmission rates and overall and minor in-hospital complications in obese patients undergoing hip fracture surgery.
LEVEL OF EVIDENCE
III.
引言
评估长期使用胰高血糖素样肽-1（GLP-1）对不同体重指数（BMI）分层的髋部骨折手术后死亡率、再入院率、院内并发症发生率及植入物失败发生率的影响。
方法
利用一家机构的前瞻性髋部骨折登记处（2014 - 2024年），确定58例受伤时正在接受长期GLP-1治疗的肥胖患者。将这些患者（A组）按年龄、骨折类型和合并症负担与基于BMI的对照组进行匹配：正常体重（B组）、超重（C组）和肥胖（D组）。比较术后并发症发生率、再入院率和植入物失败率。主要并发症定义为需要进一步手术、延长住院时间或导致严重功能障碍的事件。次要并发症为只需极少治疗即可处理的情况。统计分析包括方差分析、卡方检验和事后残差检验。数据使用IBM SPSS Statistics（版本21.0，伊利诺伊州芝加哥）进行分析。
结果
共纳入232例患者（每组58例）。各队列次要并发症发生率差异显著（χ²≈15.25，p < 0.01）：A组为17.24%，B组为37.93%，C组为51.72%，D组为48.28%。总体并发症发生率在各组间差异显著（χ²≈17.33，p < 0.001）：A组为22.41%，B组为55.17%，C组为51.72%，D组为60.34%。D组30天（17.24%，p < 0.001）和90天（24.14%，p < 0.05）再入院率显著更高。在主要并发症、硬件失败发生率或30天或1年时未观察到显著差异。
结论
连续使用GLP-1受体激动剂≥6个月与接受髋部骨折手术的肥胖患者30天和90天再入院率以及总体和次要院内并发症的减少相关。
证据水平
III级
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