Windows in the ICU and Postoperative Delirium: A Retrospective Cohort Study

Area of Science:

• Critical Care Medicine
• Environmental Psychology
• Hospital Design

Background:

• The intensive care unit (ICU) built environment is recognized for its potential influence on patient outcomes.
• The presence of windows in ICU rooms has been hypothesized to affect patient well-being and clinical conditions like delirium.

Purpose of the Study:

• To investigate the association between the presence or absence of windows in ICU patient rooms and the incidence of ICU delirium.
• To explore the relationship between windowed rooms and various secondary outcomes including length of stay and mortality.

Main Methods:

• A retrospective single-institution cohort study design was employed.
• Delirium was assessed using the Confusion Assessment Method for the ICU (CAM-ICU).
• Patient data from January 1, 2020, to September 1, 2023, were analyzed, categorizing patients into windowed or non-windowed room groups.

Main Results:

• A total of 3527 patient encounters were analyzed; 37% were in non-windowed rooms.
• Delirium occurred in 21% of patients in windowed rooms versus 16% in non-windowed rooms.
• Adjusted analyses revealed a significant association between windowed rooms and increased odds of delirium (OR, 1.29; 95% CI, 1.07-1.56; p = 0.008).

Conclusions:

• The presence of windows in ICU rooms is associated with a higher incidence of delirium.
• Findings suggest that the ICU's built environment, specifically window access, may be a modifiable factor influencing delirium.
• Further research is warranted to explore causative mechanisms and potential interventions.