{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T20:02:33Z","timestamp":1784404953636,"version":"3.55.0"},"reference-count":22,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2024,8,3]],"date-time":"2024-08-03T00:00:00Z","timestamp":1722643200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2024,8,3]],"date-time":"2024-08-03T00:00:00Z","timestamp":1722643200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["associationofanaesthetists-publications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Anaesthesia"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Approximately 1% of the UK population take oral corticosteroids for \u2265\u200928\u2009days each year, for broadly two reasons: deficiency in corticosteroid requiring replacement; or therapeutic corticosteroid for inflammatory conditions. Acute deficiency can occur at times of physiological stress (e.g. surgery), potentially leading to major complications. The Association of Anaesthetists' 2020 consensus guideline provides detailed advice for the management of glucocorticoids during the peri\u2010operative period for patients with adrenal insufficiency. This national audit aimed to assess compliance with this guideline.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data were collected from 59 Trusts over 14 consecutive days for all eligible patients undergoing procedures under the care of an anaesthetist. Patients who were prescribed \u2265\u20095\u2009mg oral prednisolone equivalents pre\u2010operatively, in whom supplementary corticosteroid would be indicated, were compared with those prescribed &lt;\u20095\u2009mg oral prednisolone equivalents.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Operations for 21,731 patients were audited: 277 (1.3%) patients were taking therapeutic corticosteroids. Detailed peri\u2010operative data were collected for all patients receiving therapeutic corticosteroids: 201\/277 (73%) were ASA physical status \u2265\u20093; 184\/277 (66%) underwent elective procedures; and 252\/277 (91%) were prescribed prednisolone pre\u2010operatively, of whom 219\/277 (79%) were prescribed \u2265\u20095\u2009mg oral prednisolone equivalents. In the patients who were prescribed \u2265\u20095\u2009mg oral prednisolone equivalents, 186\/219 (85%) received pre\u2010operative glucocorticoid supplementation and 97\/219 (42%) received it postoperatively; however, only 67\/219 (31%) and 43\/219 (20%) respectively received glucocorticoid supplementation according to the guidelines. Overall, peri\u2010operative prescribing was compliant in 19\/219 (9%) patients. A similar proportion, 30\/219 (14%), received no supplementation. In the patients taking &lt;\u20095\u2009mg oral prednisolone equivalents pre\u2010operatively, 28\/58 (48%) received inappropriate supplementation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Despite 125\/277 (45%) of anaesthetists reporting Association of Anaesthetists' guidelines use, compliance remained low, with adherence in only 27\/125 (22%) patients. Further research is required to identify the correct peri\u2010operative strategy for patients taking therapeutic corticosteroids.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/anae.16388","type":"journal-article","created":{"date-parts":[[2024,8,3]],"date-time":"2024-08-03T07:49:41Z","timestamp":1722671381000},"page":"1042-1052","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Peri\u2010operative Replacement of Exogenous Steroids (\n                    <scp>PREdS<\/scp>\n                    ): a national audit of current peri\u2010operative prescribing for patients taking therapeutic steroids"],"prefix":"10.1111","volume":"79","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-0701-7239","authenticated-orcid":false,"given":"Oliver J. H.","family":"Barker","sequence":"first","affiliation":[{"name":"Department of Anaesthesia University Hospitals Bristol and Weston  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8302-7097","authenticated-orcid":false,"given":"Aravind V.","family":"Ramesh","sequence":"additional","affiliation":[{"name":"Department of Health Sciences University of Bristol  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inthu","family":"Kangesan","sequence":"additional","affiliation":[{"name":"Department of Critical Care Guy's and St Thomas' NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7260-188X","authenticated-orcid":false,"given":"Jonathan","family":"Barnes","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia University Hospitals Bristol and Weston  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0584-0079","authenticated-orcid":false,"given":"Suzanne","family":"Harrogate","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia North Bristol NHS Trust  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Swati","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia University Hospitals Bristol and Weston  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5101-9487","authenticated-orcid":false,"given":"Barnaby C.","family":"Reeves","sequence":"additional","affiliation":[{"name":"Bristol Trials Centre University of Bristol  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3635-6212","authenticated-orcid":false,"given":"Ben","family":"Gibbison","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia University Hospitals Bristol and Weston  Bristol UK"},{"name":"Bristol Medical School University of Bristol  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the PREdS Trainee Research Network Collaborators","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,8,3]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"NHS Business Services Authority.Prescription Cost Analysis \u2013 England 2020\/21.2021.https:\/\/www.nhsbsa.nhs.uk\/statistical\u2010collections\/prescription\u2010cost\u2010analysis\u2010england\/prescription\u2010cost\u2010analysis\u2010england\u2010202021(accessed 08\/11\/2021)."},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1530\/eje\u201015\u20100608"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfac044"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1210\/jendso\/bvac185"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/ccm.0000000000000773"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.14963"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000001659"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.cd005367.pub2"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0039\u20106060(97)90280\u20104"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600\u2010051x.1999.260903.x"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.15176"},{"key":"e_1_2_6_13_1","unstructured":"National Institute for Health and Care Excellence.Routine pre\u2010operative tests for elective surgery. 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