Abstract
Due to the severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) pandemic, many hospitals imposed a no-visitation policy for visiting patients in hospitals to prevent the transmission of SARS-CoV-2 among visitors and patients. The objective of this study was to investigate the association between the no-visitation policy and delirium in intensive care unit (ICU) patients. This was a single-center, before-after comparative study. Patients were admitted to a mixed medical-surgical ICU from September 6, 2019 to October 18, 2020. Because no-visitation policy was implemented on February 26, 2020, we compared patients admitted after this date (after phase) with the patients admitted before the no-visitation policy (before phase) was implemented. The primary outcome was the incidence of delirium during the ICU stay. Cox regression was used for the primary analysis and was calculated using hazard ratios (HRs) and 95% confidence intervals (CIs). Covariates were age, sex, APACHE II, dementia, emergency surgery, benzodiazepine, and mechanical ventilation use. Of the total 200 patients consecutively recruited, 100 were exposed to a no-visitation policy. The number of patients who developed delirium during ICU stay during the before phase and the after phase were 59 (59%) and 64 (64%), respectively (P = 0.127). The adjusted HR of no-visitation policy for the number of days until the first development of delirium during the ICU stay was 0.895 (0.613-1.306). The no-visitation policy was not associated with the development of delirium in ICU patients.
Highlights
Delirium is an important problem for critically ill patients, occurring in 83% of mechanically ventilated patients during their intensive care unit (ICU) stay, and in approximately 30% of patients during their ICU stay [1–3]
The number of patients who developed delirium during ICU stay during the before phase and the after phase were 59 (59%) and 64 (64%), respectively (P = 0.127)
The no-visitation policy was not associated with the development of delirium in ICU patients
Summary
Delirium is an important problem for critically ill patients, occurring in 83% of mechanically ventilated patients during their intensive care unit (ICU) stay, and in approximately 30% of patients during their ICU stay [1–3]. Various interventions have been conducted to prevent delirium in critically ill patients [5, 6]. Among these interventions, visitation has been considered as a possible measure to prevent delirium [7]. Visitors are allowed to visit at any time and approximately 30% of the world’s ICUs use this method [9]. In flexible visitation, which was used in past research interventions, visitors were allowed 12 hours of visitation per day [7, 10]. The objective of this study was to investigate the association between the no-visitation policy and delirium in intensive care unit (ICU) patients
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