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GLP-1 use was associated with fewer 90-day complications after joint replacement

The Bone & Joint Journal (PubMed)Aug 1, 2026

AI-summarized from the linked source. Educational brief, not medical advice.

Brief summary

A meta-analysis of 10 matched cohort studies involving 96,356 hip or knee arthroplasty patients associated preoperative GLP-1 receptor agonist treatment with fewer 90-day surgical and medical complications and readmissions.

What NurseJet pulled from the source

The pooled risk ratio for 90-day surgical complications was 0.73, with lower pooled medical complications and readmissions as well. However, all included studies were observational, two had serious and eight had moderate overall risk of bias, and GRADE certainty was very low for every outcome except cost.

Why this matters for nurses

Medical-surgical nurses reconcile GLP-1 therapy, monitor postoperative recovery, and reinforce medication hold and restart plans. The association is clinically interesting but does not establish that perioperative initiation prevents complications.

Bedside takeaway

Lower pooled complication rates are hypothesis-supporting, not a reason to initiate or continue GLP-1 therapy independently.

How This Applies in Practice

Use this when: Reconciling perioperative medications for a hip or knee arthroplasty patient who uses a GLP-1 receptor agonist.

On your shift

Verify the GLP-1 agent, indication, dosing interval, last dose, documented hold, glucose plan, and restart instructions.
Follow the approved postoperative assessments for wound, pain, mobility, hydration, gastrointestinal symptoms, and glucose.
Use teach-back at discharge for the medication restart plan, wound concerns, urgent symptoms, and scheduled follow-up.

Keep in mind: The evidence was observational and very low certainty for clinical outcomes; it does not establish independent initiation or continuation. Follow the perioperative protocol, facility policy, and provider orders.

Key takeaways

The review included 10 matched cohort studies and 96,356 hip or knee arthroplasty patients.
GLP-1 treatment was associated with fewer 90-day surgical and medical complications.
Ninety-day readmission was also lower in the pooled GLP-1 groups.
Evidence certainty was very low for all clinical outcomes assessed.

Practice implications

Verify the exact GLP-1 agent, indication, last dose, perioperative hold, glucose plan, and prescribed restart timing. Monitor recovery using the approved surgical pathway and escalate wound, gastrointestinal, glucose, hydration, or other concerning findings.

Limitations & cautions

All included studies were matched observational cohorts, so residual confounding may explain some of the association. Overall risk of bias was moderate or serious, certainty was very low for clinical outcomes, and hip and knee subgroup findings differed.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations

Exact source links

Open source

Public citations are filtered to exact credible source pages. Homepage-only or invalid links stay in admin review and are not shown here.

The Bone & Joint Journal (PubMed)

The Bone & Joint Journal (PubMed). Glucagon-like peptide-1 receptor agonists are associated with improved 90-day outcomes after total hip and knee arthroplasty : a systematic review and meta-analysis.

Open original source

https://pubmed.ncbi.nlm.nih.gov/42538001/

Professional education only

This summary does not replace clinical judgment, facility policy, provider orders, or official guidelines. Verify practice changes against the original source and local protocol.

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A single-center retrospective cohort found that approximately one quarter of laboratory-defined acute kidney injury cases on internal medicine wards were not documented, particularly when maximal creatinine was lower.

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Among 161 adult hospitalizations meeting serum-creatinine criteria for acute kidney injury, 39 cases (24.2%) were undocumented. Length of stay and in-hospital mortality did not differ significantly by documentation status.

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In the 149 hospitalizations with a demonstrable creatinine change, 33 cases (22.1%) were undocumented.
Higher maximal creatinine was associated with lower adjusted odds of underdocumentation.
The study did not test whether a detection or documentation intervention improves care or outcomes.

Why this matters on shift

A smaller creatinine rise may receive less attention even when it meets the study's laboratory definition of acute kidney injury, which can affect how renal risk is communicated across the inpatient team.

Bedside takeaway

Trend ordered renal-function results and communicate clinically important changes through local escalation and documentation workflows.

Nursing implications

Trend ordered renal-function results and communicate clinically important changes through the care team according to local escalation and documentation workflows.

Limitations & cautions

Abstract-only summary. This was a retrospective, single-center study of 161 hospitalizations; urine-output criteria and reliable preadmission creatinine values were unavailable, and the reference creatinine method may affect case classification.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations · exact source links

Renal failure (PubMed). Underdocumentation of laboratory-defined acute kidney injury in internal medicine wards: a retrospective cohort study.

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AI-summarized from the linked source. Review the original article before applying to practice.

European heart journal (PubMed)Sep 6, 2026Research Article

In the pragmatic TARGET-D randomized trial, vitamin D dosing titrated to a serum target did not significantly reduce the composite of death, recurrent myocardial infarction, heart-failure hospitalization, or stroke after myocardial infarction.

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Among 630 participants followed for an average of 4.2 years, major cardiovascular events occurred in 15.7% with targeted vitamin D management and 18.4% with usual care (hazard ratio 0.85, 95% CI 0.58 to 1.24; P=0.40).

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At baseline, 87% of participants had a 25-hydroxyvitamin D level of 40 ng/mL or lower.
The primary composite outcome and the individual outcomes of death, heart-failure hospitalization, and stroke were not significantly different.
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Why this matters on shift

The trial cautions against presenting targeted vitamin D supplementation as a proven strategy for reducing major cardiovascular events after myocardial infarction.

Bedside takeaway

Present vitamin D as prescribed supplementation, not as a replacement for established post-MI secondary prevention.

Nursing implications

Reinforce the prescribed secondary-prevention plan and avoid implying that vitamin D replaces therapies with established post-MI benefit.

Limitations & cautions

Abstract-only summary. The trial included 630 participants, 78.1% were men, the primary confidence interval included benefit and no benefit, and individual secondary outcomes were not the primary endpoint.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations · exact source links

European heart journal (PubMed). Targeted vitamin D supplementation and major adverse cardiovascular events after myocardial infarction: the TARGET-D trial.

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A prospective Dutch nursing-home cohort found clinically important differences in illness burden across respiratory viruses, with influenza and human metapneumovirus standing out.

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Why this matters on shift

Frailty can amplify respiratory-infection consequences, and the causative virus may help anticipate recovery, oxygen, mobility, and secondary-infection needs.

Bedside takeaway

Trend oxygen needs, mobility, recovery, and secondary-pneumonia signs during nursing-home respiratory infections.

Nursing implications

During outbreaks or suspected infection, trend oxygen needs, mobility and time in bed, recovery, and signs of bacterial pneumonia according to facility protocols.

Limitations & cautions

Abstract-only summary. Data came from 15 Dutch nursing homes, the overall suspected-infection risk estimate was imprecise, and virus-outcome comparisons may be affected by confounding and small subgroup counts.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations · exact source links

Journal of the American Medical Directors Association (PubMed). Clinical Impact of Acute Respiratory Virus Infections in Nursing Home Residents.

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AI-summarized from the linked source. Review the original article before applying to practice.

How This Applies in Practice

Key takeaways

Practice implications

Limitations & cautions

Exact source links

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