Effect of Glucagon-like Peptide-1 Receptor Agonists on Outcomes After Hip Hemiarthroplasty for Femoral Neck Fractures in Patients With Type 2 Diabetes

The use of glucagon-like peptide-1 receptor agonists (GLP-1RA) in patients with type 2 diabetes mellitus (T2DM) has increased substantially over the past several years. The purpose of this study was to determine whether GLP-1RA use affects outcomes after hip hemiarthroplasty (HA) for femoral neck fractures (FNFs). A retrospective cross-sectional analysis of a local hospital system database was conducted between 2016 and 2023 to identify patients with T2DM aged at least 18 years who underwent HA for FNFs and were on a GLP-1RA at the time of injury. A 1:1 random patient sample of those who underwent HA and were not on a GLP-IRA was used as a control. Patient characteristics and Elixhauser comorbidity index were recorded. Outcomes included hospital length of stay, aspiration pneumonitis during index hospitalization, inpatient readmissions and emergency department encounters within 365 days, medical complications, surgical site infection, implant complications, revision hip surgery, and in-hospital mortality/discharge to hospice within 30, 90, and 365 days. Binary logistic regression was done to assess the 30-day risk of medical and the 365-day risk of implant postoperative outcomes. Four hundred ninety-nine patients (GLP-1RA, N = 248; No GLP-1RA, N = 251), with T2DM, who underwent HA for FNF were included for analysis. GLP-1RA use was not markedly associated with medical complications within 30, 90, or 365 days; implant complications or revision surgery within 365 days; in-hospital mortality/discharge to hospice within 30 or 90 days; postoperative aspiration; length of stay; or inpatient readmissions or emergency department encounters. GLP-IRA use was associated with a decreased risk of in-hospital mortality/discharge to hospice within 365 days. When controlling for confounding variables, the use of GLP-IRA was not associated with any adverse outcome measured in the study (P > 0.05). GLP-1RA use in T2DM patients undergoing HA for FNF is not associated with an increased risk of early postoperative medical and surgical complications.