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PREdS
PREdS
Peri-operative Replacement of Exogenous Steroids (PREdS)
Peri-operative Replacement of Exogenous Steroids (PREdS)
STAR - Severn Trainee Anaesthetic Research
STAR - Severn Trainee Anaesthetic Research
Chief Investigator: Dr Ben Gibson
PREdS was a prospective, multicentre study assessing the number of patients presenting for elective, urgent or emergency procedures who were taking long-term oral steroids, and to determine how perioperative steroid replacement is currently being managed.
Data collection included all patients aged 18 and above, having procedures that required input of an anaesthetist (general, regional or sedation with monitoring) across all medical and surgical specialties.
Data collection took place over a consecutive 14 day period within the study window of 26th September - 4th December 2022.
Primary objectives
To assess compliance with current glucocorticoid supplementation consensus guidelines.
Secondary objectives
Describe patient demographics, indication for glucocorticoid therapy, prescribed dose (to include medication, dose, duration, route, and frequency), planned operation, peri-operative supplementation practices, and the number of patients presenting for procedures who are taking therapeutic glucocorticoids.
You can find more information here.
Summary of results
Summary of results
277/21,731 patients (1.3%) undergoing procedures under the care of an anaesthetist were taking therapeutic corticosteroids.
Most patients taking therapeutic corticosteroids were prescribed prednisolone, and 219/277 (79.1%) were taking ≥5 mg oral prednisolone equivalent pre-operatively.
Among patients taking ≥5 mg oral prednisolone equivalent, 186/219 (84.9%) received pre-operative glucocorticoid supplementation, but only 67/219 (30.6%) received supplementation in line with guideline recommendations.
Postoperative glucocorticoid supplementation was less common: 97/219 (44.3%) received it, and only 43/219 (19.6%) did so in line with guideline recommendations.
Overall peri-operative prescribing was compliant with guideline recommendations in only 19/219 patients (8.7%).
30/219 patients (13.7%) taking ≥5 mg oral prednisolone equivalent received no peri-operative supplementation, while 28/58 patients (48.3%) taking <5 mg oral prednisolone equivalent received inappropriate supplementation.
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