The Science of Preventing Delirium: Trends, Knowledge Gaps, and Future Directions Revealed Through Bibliometric Insights.

PURPOSE: To examine global research trends in delirium prevention through a bibliometric analysis and provide a structured overview of its development and emerging directions. DESIGN: A bibliometric analysis. METHODS: Data were retrieved from the Web of Science Core Collection, focusing on publications between January 1, 2015, and December 31, 2024. The analysis utilized VOSviewer, CiteSpace, and the Bibliometrix R package to evaluate publication trends, contributing countries, institutions, authors, and research focus areas. FINDINGS: Annual publication output increased steadily from 2015 to 2024, indicating a growing research interest in postoperative delirium. The United States contributed the largest share of publications (26.8%), followed by China (12.1%), Japan (8.5%), and Australia (6.7%). Harvard University and Harvard Medical School were the most productive institutions. Inouye SK and Ely EW were the most prolific authors. International collaboration was centered on a network involving the United States, China, and Germany. The most-cited article was by Su X et al in The Lancet (2016; 512 citations), and the most locally cited reference was Inouye SK's Confusion Assessment Method (1990; 268 citations). Keyword analysis identified 11 major research themes, including postoperative delirium, cognitive impairment, dexmedetomidine, nursing-led nonpharmacological interventions, dementia, advanced age, machine learning, electroencephalogram monitoring, neuroinflammation, intensive care unit, cardiac surgery, and hip fracture. CONCLUSIONS: Research on postoperative delirium prevention has increased steadily over the past decade, with the United States and leading academic institutions contributing substantially to the field. Current research has focused on major risk factors and preventive interventions, while emerging topics such as machine learning, electroencephalogram monitoring, and neuroinflammation suggest new directions for future studies. Further research should address nonsurgical populations, integrated intervention strategies, long-term outcomes, and mechanistic pathways to support more precise and multidisciplinary prevention approaches.