GLP-1 Use Tied to Fewer Complications After Surgery

GLP-1 medications, now widely used in diabetes and obesity care, may be associated with lower rates of serious complications after surgery, according to an analysis presented at the ANESTHESIOLOGY 2026 annual meeting. The finding is encouraging, but it does not establish that the drugs themselves caused the improved outcomes.

Researchers examined records for 2,028,601 U.S. adults who underwent elective operations between January 2016 and December 2024. All procedures lasted more than an hour, and each patient remained in hospital for at least 24 hours after surgery. The data came from Epic Cosmos, a de-identified electronic health-record database covering more than 1,700 hospitals and 40,000 clinics.

Among the patients studied, 145,610 — roughly 7% — were taking a GLP-1 medication. These medicines are used to help manage blood glucose and, for some patients, body weight. The researchers matched GLP-1 users with similar patients who were not taking the drugs, then compared postoperative outcomes.

Association, not proof of a protective effect

After matching, GLP-1 use was associated with 11% lower odds of major cardiovascular complications. The study’s composite cardiovascular outcome included heart attack, heart injury, stroke and death. GLP-1 use was also associated with 8% lower odds of postoperative infection, including surgical-site infections, urinary-tract infections, pneumonia and sepsis.

Those results matter because surgery can impose substantial physiological stress. Operations can trigger inflammation and affect blood pressure, blood sugar and circulation — changes that can compound existing cardiovascular and metabolic risks. Previous research has indicated that GLP-1 medicines can reduce cardiovascular risk for some patients, but their effect in the perioperative period, before and after an operation, has been less clear.

Still, the reported figures should be read as observational evidence. Even when investigators match patients on available characteristics, people prescribed GLP-1 drugs can differ from non-users in ways that are difficult to fully capture in health records. Differences in underlying care, clinical monitoring or patient health could contribute to the association.

Questions for surgical teams

Lead author Josephine Tolan, an anesthesiologist at UTHealth Houston’s Center for Outcomes Research, said clinicians need more evidence on how GLP-1 medicines affect patients around surgery. She described the results as encouraging, while emphasizing that more research is needed to determine whether the medications are driving the apparent benefits and how they should be managed before and after operations.

That caveat is particularly important because the study does not offer a new treatment recommendation. It does not show that starting a GLP-1 medicine before an operation will prevent complications, nor does it settle questions about whether an individual patient should continue or pause a medicine around a procedure. Such decisions depend on the operation, a patient’s health and the clinical team’s assessment.

The scale of the dataset gives the analysis unusual reach. More than two million cases allow researchers to examine outcomes that are comparatively uncommon and to focus on patients undergoing a broad range of elective procedures. But scale cannot substitute for a controlled trial when the goal is to determine cause and effect.

What the study adds

The analysis adds a large real-world data point to a fast-moving question in perioperative medicine: whether medicines already used for metabolic disease influence surgical recovery. Its findings point toward two areas worth testing more directly — major cardiovascular events and infections after surgery.

For now, the most defensible conclusion is narrow. In this matched electronic-health-record analysis, patients taking GLP-1 medications had lower observed odds of specified cardiovascular complications and postoperative infections than comparable non-users. The work supports further research, rather than a change in routine care on its own.

• Study population: 2,028,601 adults having elective surgery in the U.S.
• GLP-1 users: 145,610 patients, about 7% of the cohort.
• Observed association: 11% lower odds of major cardiovascular complications.
• Observed association: 8% lower odds of postoperative infections.

As GLP-1 medicines become a more common part of everyday care, surgeons, anesthesiologists and patients will need evidence that distinguishes correlation from clinical benefit. This study provides a reason to pursue that evidence at a scale and level of rigor capable of guiding perioperative decisions.

This article is based on reporting by Medical Xpress. Read the original article.