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.

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 (χ2 ≈ 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 (χ2 ≈ 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.