Postoperative Aspiration Pneumonia Among Adults Using GLP-1 Receptor Agonists
Open accessAbstract
Importance: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have been increasingly prescribed for weight management in recent years. However, little is known about whether preoperative GLP-1 RA use is associated with a greater risk of complications after surgery. Objective: To investigate whether preoperative GLP-1 RA use is associated with postoperative aspiration pneumonia among patients undergoing common surgical procedures. Design, Setting, and Participants: This retrospective cohort study, conducted using MarketScan commercial claims databases, included patients who underwent 1 of 14 common surgical procedures from April 1, 2020, to September 30, 2022. Individuals who were younger than 18 years, underwent multiple surgical procedures, or had a preoperative history of pneumonia or acute respiratory failure in the 90 days preceding surgery were excluded. Data were analyzed from December 2023 to March 2024. Main Outcome and Measures: The primary outcome was aspiration pneumonia in the 30-day postoperative period. Multivariable logistic regressions were performed, adjusting for patient and surgical characteristics. Results: This study included 366 476 patients (median age, 53 years [IQR, 43-62 years]), of whom 56.4% were women. In the cohort, 5931 patients (1.6%) had a preoperative prescription for a GLP-1 RA. Patients using GLP-1 RAs were more likely to be female (3502 [59.0%] vs 203 288 [56.4%]) and diagnosed with both obesity and diabetes (2819 [47.5%] vs 24 635 [6.8%]) compared with nonusers. Adjusted analysis showed no significant differences in the odds of postoperative pneumonia (odds ratio, 0.78; 95% CI, 0.57-1.06; P = .12) between GLP-1 RA users and nonusers. Conclusions and Relevance: This cohort study found no significant association between the preoperative use of GLP-1 RAs and short-term postoperative aspiration pneumonia despite growing concerns about the adverse effects of these medications after surgery. This finding suggests that it may be beneficial to reassess the preoperative withholding guidelines for GLP-1 RAs.
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A large retrospective cohort study involving over 360,000 surgical patients found no significant difference in 30-day postoperative aspiration pneumonia between GLP-1 RA users and non-users (OR 0.78, 95% CI 0.57, 1.06).
“Separately, a large retrospective cohort study involving over 360,000 surgical patients found no significant difference in 30-day postoperative aspiration pneumonia between GLP-1 RA users and non-users (OR: 0.78, 95% CI 0.57, 1.06).88”
From The expanding role of GLP-1 receptor agonists: a narrative review of current evidence and future directions (2025) · cites this paper as [88]
Population-based studies have reported mixed findings on the potential association between GLP-1RA use and aspiration pneumonia.
“Population-based studies have reported mixed findings on the potential association between GLP-1RA use and aspiration pneumonia (39–44).”
From The science of safety: adverse effects of GLP-1 receptor agonists as glucose-lowering and obesity medications (2026) · cites this paper as [41]
In some retrospective studies, no increase in risk of aspiration pneumonia was found in association with GLP-1 RAs.
“In some retrospective studies, no increase in risk of aspiration pneumonia was found in association with GLP-1 RAs (159,160).”
From 16. Diabetes Care in the Hospital: Standards of Care in Diabetes—2026 (2026) · cites this paper as [159]
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16. Diabetes Care in the Hospital: Standards of Care in Diabetes—2026
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- Authors
- Chen, Y.-H., Zink, T., Chen, Y.-W., Nin, D. Z., Talmo, C. T., Hollenbeck, B. L., Grant, A. R., Niu, R., Chang, D. C., & Smith, E. L.
- Affiliations
- Harvard University (US)
- Tufts Medical Center (US)
- New England Baptist Hospital (US)
- Corresponding author
- Smith, Eric L.
- ORCID
- Venue
- JAMA Network Open
- Publisher
- American Medical Association (AMA)
- Published
- 2025-03-04
- Volume
- 8
- Issue
- 3
- Pages
- e250081
- ISSN
- 2574-3805 (ISSN-L)
- PMC
- PMC11880946
- OpenAlex
- W4408149182
- Cited by
- 60
- References
- 13
- Citations by year
- 2026: 32 · 2025: 28
- FWCI
- 41.92
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- JAMA Network Open (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac, Anesthesia and Surgical Outcomes
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Airway Management and Intubation Techniques
- Keywords
- GLP-1 receptor agonists, preoperative medication use, surgical complications, obesity, diabetes mellitus, weight management
- MeSH terms
- Glucagon-Like Peptide-1 Receptor, Glucagon-Like Peptide-1 Receptor Agonists, Adult, Female, Humans, Male, Middle Aged, Pneumonia, Aspiration, Postoperative Complications, Retrospective Studies
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