What follows are highlights from these studies:

Association of GLP-1 Receptor Agonist Medication Duration of Use and Withholding Time with Predicted Probability of Preoperative Full Stomach

GLP-1 receptor agonists, including medications commonly prescribed for diabetes and weight management, can delay gastric emptying, raising concerns that patients may still have food or liquid in their stomach at the time of surgery. This can increase the risk of aspiration, a potentially serious complication during anesthesia.

In a multicenter study, researchers examined whether GLP-1 receptor agonist use and medication withholding times were associated with the likelihood of a full stomach before surgery. While patients taking GLP-1 medications had slightly higher rates of a predicted full stomach than those not taking the medications, the difference was smaller than expected. Researchers noted that prolonged fasting before surgery may have contributed to the findings, though fasting alone did not eliminate the risk, as some full-stomach patients in the GLP-1 group had fasted for more than 23 hours.

"As concerns have grown about delayed gastric emptying in patients taking GLP-1 medications, many clinicians have looked to longer fasting times as a potential strategy to reduce risk," said Oliver Panzer, MD, anesthesiologist at HSS and co-author of the study. "Our findings suggest that extended fasting may help reduce the likelihood of a full stomach, but it is unlikely to eliminate the risk entirely. However, because this was an observational study, we cannot conclude that longer fasting times directly caused the lower rates of full stomach observed in some patients. Additional research is needed to better understand the factors that influence gastric emptying and perioperative risk in patients taking GLP-1 medications."

Interrater Reliability of Preoperative Gastric Ultrasound in Patients Using Cannabis

Gastric ultrasound is increasingly used before surgery to help determine whether a patient's stomach is empty or still contains food or fluid that could increase aspiration risk during anesthesia. Although established guidelines exist for interpreting these ultrasound images, researchers found that assessing stomach contents in patients who use cannabis may be more challenging than expected.

The study's key finding was poor agreement among four experienced point-of-care ultrasound clinicians reviewing gastric ultrasound images, suggesting that existing ultrasound criteria may not always provide clear guidance in patients who use cannabis. One potential challenge is the presence of air in the gastric antrum, which can appear in both empty and full stomachs and may complicate interpretation.

“We found considerable variation among experienced clinicians reviewing the same ultrasound images," said Stephen Haskins, MD, anesthesiologist at HSS and co-author of the study. "The findings suggest that additional refinement of gastric ultrasound criteria may be needed to improve consistency, reduce uncertainty, and support clearer perioperative decision-making."

Implications for Preoperative Decision-Making

Together, these studies underscore the growing complexity of preoperative stomach assessment as patient populations and medication-use patterns evolve. The GLP-1 study suggests that longer fasting periods may help reduce the risk of a full stomach before surgery, though fasting alone may not completely eliminate risk. Meanwhile, the cannabis study highlights potential limitations in current gastric ultrasound criteria.

Collectively, the findings suggest that assessing aspiration risk may require a more individualized approach and that additional research is needed to refine the tools and guidelines clinicians use to make perioperative decisions. Researchers hope the studies will help inform future efforts to improve patient safety and anesthesia care.

For the eighth consecutive year, Hospital for Special Surgery (HSS) has earned the “LGBTQ+ Healthcare Equality Leader” designation from the Human Rights Campaign Foundation (HRC), the largest lesbian, gay, bisexual, transgender and queer (LGBTQ+) civil rights organization in the United States. The designation was awarded in the 15th edition of HRC’s Healthcare Equality Index (HEI).

The HEI is the nation’s foremost benchmarking survey of healthcare facilities on policies and practices dedicated to the equitable treatment and inclusion of LGBTQ+ patients, visitors, and employees. HSS is among the top 10% of Leaders in LGBTQ+ Healthcare Equality that have received this designation consecutively for eight years.

“We’re honored to receive this recognition as it is a testament to our steadfast commitment in diversity and inclusion and unwavering support of the LGBTQ+ community,” said Bryan T. Kelly, MD, MBA, HSS surgeon-in-chief and medical director. “At HSS, we remain driven by our core values, which include fostering an environment of respect, equitable treatment, and opportunity for all of our patients, their families, and employees.”

The Office of Diversity, Equity, and Inclusion (DEI) leads the adoption of initiatives, behaviors, attitudes, and policies that enhance cultural humility and inclusion at HSS, and is actively devoted to advancing awareness, training and education and implementing best practices throughout the organization.

“Beyond our promise to deliver patient-centered care to the LGBTQ+ community in a safe, healing, and welcoming environment, HSS is committed to identifying and addressing health disparities that affect vulnerable populations,” said Stephen C. Haskins, MD, anesthesiologist and chief medical diversity officer at HSS. “As leaders in healthcare and in our communities, we strive to assess gaps in practice, education, and training to continually improve health equity, equality, and access for all.”

Through the Office of DEI, HSS has established a hospital-wide LGBTQ+ Committee that evaluates and promotes policies and practices, education, and communications that will contribute to a high-quality healthcare experience for LGBTQ+ patients and is consistent with HSS’ commitment to excellence. The Committee plans and implements appropriate education interventions, guidelines and policies for HSS staff, including mandatory LGBTQ+ sensitivity trainings each year and the integration of preferred name, pronouns, gender identity and sexual orientation data collection into the electronic medical record.

“The Human Rights Equality Index is the industry standard for measuring patient services and support, training, employee policies and patient and community engagement to promote LGBTQ+ equality,” Jillian A. Rose-Smith, PhD, MPH, LCSW, assistant vice president, community engagement, diversity and research at HSS. “We are proud to partner with the LGBTQ+ community to continue to enhance our own awareness of best practice knowledge and interventions that helps us better optimize care outcomes for our patients and their loved ones.”

As part of ongoing DEI efforts, HSS recently launched an Employee Resource Group (ERG) program to elevate employee voices and create safe spaces for different affinity groups. The ERGs will support employee wellness and the ideation of DEI initiatives.

For the past four years, HSS has been a proud sponsor of the NYC Pride March, highlighting its commitment to caring for and supporting LGBTQ+ patients and HSS employees.