Department of Acute and Critical Care Nursing, School of Nursing, Sapporo City University, Sapporo, Hokkaido, Japan.
Intensive Care Unit, Kin-ikyo Chuo Hospital, Sapporo, Hokkaido, Japan.
PLoS One. 2022 Mar 9;17(3):e0265082. doi: 10.1371/journal.pone.0265082. eCollection 2022.
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.
由于严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）大流行，许多医院对住院患者实施了禁止探视政策，以防止 SARS-CoV-2 在访客和患者之间传播。本研究的目的是调查禁止探视政策与重症监护病房（ICU）患者谵妄之间的关系。
这是一项单中心前后对照研究。患者于 2019 年 9 月 6 日至 2020 年 10 月 18 日入住综合内科-外科 ICU。由于 2020 年 2 月 26 日实施了禁止探视政策，因此我们比较了该日期之后（后阶段）入住的患者与禁止探视政策实施之前（前阶段）入住的患者。主要结局是 ICU 住院期间谵妄的发生率。使用 Cox 回归进行主要分析，并计算危险比（HRs）和 95%置信区间（CIs）。协变量为年龄、性别、急性生理学与慢性健康状况评分系统 II（APACHE II）、痴呆、急诊手术、苯二氮䓬类药物和机械通气的使用。
在连续招募的 200 名患者中，有 100 名患者接触了禁止探视政策。在前阶段和后阶段，ICU 住院期间发生谵妄的患者人数分别为 59 例（59%）和 64 例（64%）（P=0.127）。禁止探视政策对 ICU 住院期间首次发生谵妄的天数的调整 HR 为 0.895（0.613-1.306）。
禁止探视政策与 ICU 患者谵妄的发生无关。
