Jack Reeves, Sascha Karunaratne, Kate Alexander, Alexandria Paige Petridis, Sharon Carey, Haryana M. Dhillon, Linda Denehy, Michael Solomon, Bernhard Riedel, Cherry Koh, Kate McBride, Chelsia Gillis, Kate White, Nicholas Hirst, Zaid Shadid, Ishraque Rahman, Neil Pillinger, Daniel Steffens, Global (P)rehabilitation Initiative Collaborative Group, Abdalla Mohamed Hadhoud, Abdelatte Ghanam, Abdelilah Ghannam, Abdelmoiz Mohamed, Abdelrahim Ahmed, Abdelrahman Mohamedali, Abdirahman Osman, Abdulaleem A. Esmail, Abdulhamid Shaban, Abdulrahman Mohammed, Abdulzahra Hussain, Abdullah Al-Mehdhar, Abdullah Alyami, Achraf Drissi-El-Bouzaidi, Aeshah Alqathafi, Ahmed Ahmayda, Ahmed Elsayed Tharwat Abdelsalam, Ahmed Ibrahim MohamedMohamed, Ahmed Musbah, Ahmed Shoman, Ahmed A. Wahaballah, Aiman Al-Touny, Aiman Hussien, Akrem Amer, Amina Houmada, Amr Badawy, Andrea B. Maier, Andreas Denys, Andrew Davies, Angel Becerra-Bolaños, Angela Jerath, Anjum Khan Joad, Anthony Absalom, Areej Ahmed Al-Qaidani, Aras Emre Canda, Ashleigh Maske, AshuSara Mathai, Awab Hamid Eltayeb Hamid, Ayah Attallah, Ayten Saracoglu, Badr Aldeen Al-Tayar, Barbara Sinner, Basantha Kumar Rayani, Behiç Girgin, Bernhard Riedel, Bisher Sawaf, Birgitte Brandstrup, Bodil Andersson, Brendan John Moran, B. Roxburgh, Bruno Romanò, Carol Keen, Catarina Tiselius, Chelsia Gillis, Chloe Grimmett, Christian M. Beilstein, Cindy Yeoh, Claus Anders Bertelsen, Dario Baratti, Darren Au, David Clark, Declan Dunne, Denny Z H Levett, Despoina Liotiri, Dimitrios Schizas, Dominique Engel, Dorian Krsul, Edoardo Virgilio, Ebrahim Ali Mohammed Amrein, Eleni Kitsou, Elharith Abduelfattah Gaber Mohammed, Εlissavet Anestiadou, Emily Traer, Engy Elkoury, Enrique Alday Muñoz, Erik Nordenström, Erdinç Kamer, Eslam Elshenawy, Ewen M. Harrison, Fabio Ausania, Fadwa Fuad Abdulwahid Mansoor
BACKGROUND: Prehabilitation can decrease postoperative complications and enhance recovery for people with gastrointestinal cancer. Preoperative screening may identify individuals at highest risk of poor postoperative outcomes, enabling targeted and tailored interventions. Despite this, optimal tools for screening patients before surgery remain unclear. This Delphi study sought to achieve international consensus on appropriate screening tools to identify patients at increased risk of postoperative complications before undergoing gastrointestinal cancer surgery. METHODS: A three-round iterative Delphi survey was distributed to a global multidisciplinary network of prehabilitation experts. Respondents were asked to rate screening tools, identified through a scoping review, on a 5-point Likert scale based on the appropriateness of their use for adult patients undergoing gastrointestinal cancer surgery. The screening tools were categorized as evaluating either physical, nutritional, or psychological domains. A consensus criterion was applied in the second and third rounds, which required ≥ 70% of respondents to rate a given tool as ≥ 4 for it to proceed to future rounds. RESULTS: Overall, 308 self-nominated prehabilitation experts rated the screening tools. Of 26 screening tools (including 9 physical, 7 nutritional, and 10 psychological), consensus was achieved for three physical, three nutritional, and four psychological tools. CONCLUSION: Based on Delphi consensus of global prehabilitation experts, 10 self-reported screening tools reached consensus. Given that tool selection was informed by Delphi consensus rather than empirical validation, prospective studies are necessary to assess whether these instruments accurately stratify surgical risk and identify candidates most likely to benefit from prehabilitation.