Intensive Care Unit Room Characteristics and Association with the Development of Delirium

Area of Science:

• Critical Care Medicine
• Environmental Health
• Patient Outcomes

Background:

• Delirium in critically ill patients is linked to adverse outcomes.
• Environmental factors and circadian rhythm maintenance may reduce delirium.
• The impact of specific room characteristics on delirium incidence remains unclear.

Purpose of the Study:

• To investigate the association between the presence of windows or doors in patient rooms and the incidence of delirium.
• To explore the relationship between room characteristics and secondary outcomes such as length of stay and mortality.

Main Methods:

• Retrospective cohort study of adult medical patients admitted to the ICU.
• Data collected on clinical factors and room characteristics (windows, closed-format rooms).
• Primary outcome: Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) positive status; Secondary outcomes: ICU/hospital length of stay (LOS) and mortality.

Main Results:

• Neither windows nor closed-format rooms were significantly associated with delirium (CAM-ICU positivity) after multivariate analysis.
• An initial association between windows and increased hospital LOS lost statistical significance after False Discovery Rate (FDR) correction.
• No significant associations were found for ICU mortality or ICU LOS.

Conclusions:

• Room characteristics studied were not significantly associated with delirium or secondary outcomes post-FDR correction.
• The study had limited power to detect moderate differences, and an architectural influence cannot be definitively ruled out.
• Larger cohorts and more precise measurement of room characteristics are needed for further investigation.