Inflammatory Bowel Disease: Call to Standardize Perioperative Steroids

Elizabeth C. Wick, MD Assistant Professor,Department of Surgery The Johns Hopkins Hospital, Baltimore, Interview with:
Elizabeth C. Wick, MD
Assistant Professor,Department of Surgery
The Johns Hopkins Hospital, Baltimore, Maryland What are the main findings of the study?

Dr. Wick: The main finding is the high variability in physician practice for prescribing steroids and the lack of clear guidance as to best practice in the literature. Were any of the findings unexpected?

Dr. Wick: We expected post operative variability in prescribing but were quite surprised in the varied dose given in the operating room. The operating room is an area where we have embraced protocol and standardization and we expected that 100 mg would be used consistently. What should clinicians and patients take away from your report?

Dr. Wick: We need to reduce variability in care and improve adherence to evidence based guidelines. Patients should take away that frequently after surgery they may not need as high a dose of steroids as was originally believed and should consider receiving consultation from endocrinologist and/or additional tests if unclear. What recommendations do you have for future research as a result of this study?

Dr. Wick: We need to further study how to translate evidence into practice and to deliver consistent standard care. Our care system is complex and many providers are involved, we need need to evolve the system to help us be consistent.


Lamore RF, III, Hechenbleikner EM, Ha C, et al. Perioperative Glucocorticoid Prescribing Habits in Patients With Inflammatory Bowel Disease : A Call for Standardization. JAMA Surg. 2014;():. doi:10.1001/jamasurg.2013.5278.