Development and Expert Consensus of an Evidence-Based Strategy to Prevent Postoperative Delirium in Malnourished...

Cancer patients with malnutrition are at high risk for postoperative delirium. To develop a preliminary prevention strategy for postoperative delirium in malnourished cancer patients based on literature search and Delphi expert consultations.

Between August 2023 and January 2024, we followed the PIPOST (Population, Intervention, Professional, Outcome, Setting, and Type of evidence) framework to formulate clinical questions and retrieved relevant literatures using the 6S model (Systems, Summaries, Synopses of Syntheses, Syntheses, Synopses of Single Studies, and Single Studies). Based on the evidence, a preliminary strategy for preventing postoperative delirium in malnourished cancer patients was developed. Following two rounds of Delphi expert consultations, the final version of the strategy was created to develop and refine the proposed prevention strategy for postoperative delirium.

The initial literature search yielded 6218 articles, from which 20 core studies were ultimately included. The response rates for the two rounds of Delphi consultations were 96.0% and 100%, with authority coefficient 0.912 and expert concordance coefficient (Kendall's W) increased from 0.398 to 0.465 (p < 0.01). The finalized prevention strategy comprised four categories, 10 sections, and 27 items.

An evidence-based strategy for preventing postoperative delirium has been developed preliminarily. Further studies are warranted to evaluate its clinical feasibility and efficacy to reduce the incidence of postoperative delirium in malnourished cancer patients.