Kim Bomi, Cho Jaehwa, Park Jin Young, Kim Hesun Erin, Oh Jooyoung
Institute of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul, South Korea.
Department of Pulmonary and Critical Care Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.
Front Aging Neurosci. 2022 Mar 2;14:845105. doi: 10.3389/fnagi.2022.845105. eCollection 2022.
To evaluate the effect of intensive care unit (ICU) visit on the incidence of delirium, delirium subtype, and anxiety level in ICU patients.
Trained psychiatrists and nurses evaluated ICU patients for delirium, delirium subtypes, and anxiety. Propensity score matching (PSM) was used to retrospectively analyze the data. Then, we compared the differences in the incidence of delirium, delirium subtypes, and anxiety level before and after the ICU visit ban. Logistic regression was conducted to identify the risk factors for delirium subtypes and high anxiety levels.
After PSM, there was no statistically significant difference in the incidence of delirium between the non-visiting and restrictive visiting groups (non-visiting 27.4% versus restrictive visiting 30.9%, = 0.162). The proportion of hyperactive and mixed subtypes was higher in the non-visiting than in the restrictive visiting group (non-visiting 35.3 and 30.1% versus restrictive visiting 27.7 and 20.1%, = 0.002). The anxiety level was higher in the non-visiting than in the restrictive visiting group (state-trait anxiety inventory score: non-visiting 53.46 ± 4.58 versus restrictive visiting 52.22 ± 6.50, = 0.009). Patients who stayed in the ICU during the visit ban were more likely to have hyperactive ( = 0.005) and mixed subtype ( = 0.001) than those who did not. Moreover, patients who stayed in the ICU during the visit ban were more likely to experience high anxiety levels than those who did not ( < 0.001).
Prohibition of ICU visits during COVID-19 pandemic did not affect the incidence of delirium during COVID-19 but could change the delirium subtype and raise anxiety level. Moreover, visiting prohibition was a risk factor for non-hypoactive delirium subtype and high anxiety levels. Therefore, ICU visits are important in dealing with delirium subtypes and anxiety in ICU patients.
评估重症监护病房（ICU）探视对ICU患者谵妄发生率、谵妄亚型及焦虑水平的影响。
由经过培训的精神科医生和护士对ICU患者的谵妄、谵妄亚型及焦虑情况进行评估。采用倾向得分匹配法（PSM）对数据进行回顾性分析。然后，比较ICU探视禁令前后谵妄发生率、谵妄亚型及焦虑水平的差异。进行逻辑回归分析以确定谵妄亚型和高焦虑水平的危险因素。
PSM后，非探视组与限制探视组的谵妄发生率无统计学显著差异（非探视组27.4%，限制探视组30.9%，P = 0.162）。非探视组中多动型和混合型谵妄亚型的比例高于限制探视组（非探视组分别为35.3%和30.1%，限制探视组分别为27.7%和20.1%，P = 0.002）。非探视组的焦虑水平高于限制探视组（状态-特质焦虑量表评分：非探视组53.46±4.58，限制探视组52.22±6.50，P = 0.009）。在探视禁令期间留在ICU的患者比未留在ICU的患者更易出现多动型（P = 0.005）和混合型（P = 0.001）谵妄亚型。此外，在探视禁令期间留在ICU的患者比未留在ICU的患者更易出现高焦虑水平（P<0.001）。
COVID-19大流行期间禁止ICU探视未影响COVID-19期间的谵妄发生率，但可能改变谵妄亚型并提高焦虑水平。此外，禁止探视是导致非安静型谵妄亚型和高焦虑水平的危险因素。因此，ICU探视对于处理ICU患者的谵妄亚型和焦虑很重要。
