ICU delirium is affected by numerous factors, including pre-existing health problems, newly diagnosed conditions, medications, and interventions like surgery. Currently, there isn’t a consensus on which medications may effectively prevent or treat this condition. Studies indicate that the ICU environment could play a role in the onset of delirium, but more research is necessary to clarify these findings. A recent investigation revealed that patients in rooms with windows are more prone to develop delirium compared to those in windowless rooms.
Delirium is characterized by a rapid change in mental function, often resulting in variations in awareness or disorganized thought processes. It is a common challenge in the post-surgery ICU, affecting approximately 50-70% of patients, influenced by their unique risk factors.
Numerous elements contribute to ICU delirium, such as medical history, recent health complications, medication use, and surgical interventions. At this time, there is no unified consensus on pharmaceutical treatments aimed at preventing or mitigating delirium.
Although some research suggests that the ICU atmosphere may impact the likelihood of developing delirium, further studies are needed to better understand this connection. A research team from Mass General Brigham, in cooperation with Boston University Chobanian & Avedisian School of Medicine, found that patients in rooms with windows were more likely to experience delirium compared to those without windows.
By examining electronic health records, the researchers explored the link between having windows in ICU rooms and the occurrence of delirium. They discovered that 21% (460 out of 2,235) of patients in rooms with windows experienced delirium, whereas 16% (206 out of 1,292) of patients in windowless rooms did.
“The results of our study were surprising, especially given prior research highlighting the importance of circadian rhythms during hospital stays. Nevertheless, this adds to the growing evidence that healthcare design plays a crucial role in shaping patient experiences and outcomes,” said Diana Anderson, MD, FACHA, the lead author and assistant professor of neurology. She clarified that, due to the study’s nature, these intriguing results do not establish a direct cause-and-effect relationship and might indicate the varying tendencies of clinical teams to place higher-risk delirium patients in specific types of rooms.
The authors stress the need for additional research to evaluate how various window features influence patient health. “While this study improves our understanding of the link between delirium and the physical environment, it is clear that more investigations are necessary to further explore these findings. For instance, the impact of different window views—whether facing nature or urban settings—on patients, as well as other environmental factors such as light and noise, should be investigated in future studies,” Anderson elaborated.
The results of this study have been published online in the journal Critical Care Medicine.
This research was financed by an internal Pilot Grant from the Chief Academic Officer at Mass General Brigham. Additionally, Dr. Anderson’s dedicated research time received support from Jacobs Architecture and Engineering.
