Association Between Verbal Communication With Families and Delirium in Mechanically Ventilated Patients: A...

Introduction Delirium in the intensive care unit (ICU) significantly impacts patient outcomes. While family involvement may help prevent delirium in ICU patients, its effect during mechanical ventilation remains unclear. This study investigated the association between verbal communication during family visits and early post-extubation delirium in mechanically ventilated ICU patients. Materials and methods This retrospective, analytical observational study used data from the hospital's standard electronic health record (EHR) system, which includes routine medical and nursing documentation. We conducted this study in a 10-bed emergency ICU at an academic hospital in rural Japan from April 1, 2019, to December 31, 2020. We included patients aged ≥18 years who received invasive positive pressure ventilation for >48 hours. We excluded patients who were discharged while intubated, required a tracheostomy, or were unable to be assessed using the intensive care delirium screening checklist (ICDSC). The primary outcome was the maximum ICDSC score within 24 hours post-extubation. We conducted multiple regression analyses with ICDSC as the outcome. Results A total of 110 patients were analyzed. The mean age was 64.7 years (standard deviation ± 14.3), and 73 patients were male (66.4%). The median duration of intubation was five days (interquartile range (IQR), 4-8), and the median sequential organ failure assessment (SOFA) score was 8 (IQR, 6-11). The median ICDSC within 24 hours post-extubation was 3 (IQR, 2-5). Of the total 110 patients, 28 (25.5%) could communicate verbally. Patients who could communicate verbally had lower SOFA scores, longer duration of intubation, more frequent family visits, and higher intensive care mobility scale (IMS) scores during intubation. Neither single nor multiple regression showed a significant association between verbal communication and post-extubation ICDSC. Conclusions We did not find a statistically significant association between verbal communication during family visits with patients and ICDSC within 24 hours post-extubation. Potential confounders and variations in care practices may have influenced the results. Further studies are needed to address these limitations.