Glucagon-like peptide-1 agonists may raise infection risk after ankle fusion procedures
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Key takeaways:
- Patients prescribed glucagon-like peptide-1 agonists had a significantly higher postoperative infection rate vs. the nontreatment group.
- Postoperative pseudoarthrosis rates were not different between the groups.
Presented results showed glucagon-like peptide-1 agonists may predispose patients with type 2 diabetes undergoing tibiotalar fusion, subtalar fusion or triple arthrodesis to postoperative infection.
Michael F. Levidy, MD, a PGY-2 at the Milton S. Hershey Medical Center at Penn State Health, and colleagues retrospectively performed a database query using CPT and ICD codes to identify patients with type 2 diabetes who underwent tibiotalar fusion, subtalar fusion or triple arthrodesis between 2005 and 2024. Levidy and colleagues categorized patients into two propensity-matched cohorts of 708 patients each, depending on whether they were prescribed glucagon-like peptide-1 (GLP-1) agonists within a year prior to surgery.
In his presentation at the American Orthopaedic Foot & Ankle Society Annual Meeting, Levidy said cohorts were “balanced based on age, race, sex, nicotine usage and BMI. And then we also balanced on [estimated glomerular filtration rate] eGFR and HbA1c to get a sense of how far along their diabetes had progressed and control for any kidney-related outcomes.”
Outcome measures included 1-year postoperative infection rates and pseudoarthrosis rates.
In a combined analysis of CPT and ICD codes, Levidy said patients who underwent tibiotalar fusions had a decrease in 1-year postoperative pseudoarthrosis rates, while postoperative infection rates increased at 1-year in patients who underwent either tibiotalar fusions or tarsal fusions.
Results showed patients treated with GLP-1 agonists had a significantly higher postoperative infection rate of 9% vs. 5.6% in the nontreated group. But the rate of postoperative pseudoarthrosis was not statistically significant between patients in the GLP-1 agonist group and those in the nontreatment group (9% vs. 12%), according to results.
“For CPT codes only, largely owing to the reduction in sample size associated with changing to just the granular ICD codes, we did not have any significant findings across individual surgery types,” Levidy said.
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Levidy MF, et al. The impact of GLP-1 agonist therapy in tibiotalar and subtalar fusion: A propensity-matched analysis. Presented at: American Orthopaedic Foot & Ankle Society Annual Meeting; Sept. 11-14, 2024; Vancouver, British Columbia, Canada (hybrid meeting).
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