Do you know: The study uses design features of the ICU to assess delirium
in 2025
Delirium is characterized by a sharp change in cognition, accompanied by altered consciousness or disorganized thinking. The condition is common in the post-surgical intensive care unit (ICU) setting, affecting up to 50-70% of those admitted, depending on individual risk profiles.
ICU delirium can be associated with a multitude of factors including underlying and acute medical conditions, pharmacological agents or treatment regimens such as surgery. Currently there is no definitive consensus on drug interventions that help prevent or treat delirium.
Although there is some evidence that the ICU environment plays a role in delirium, more research is needed to understand this connection. In a new study from Mass General Brigham and collaborators at Boston University’s Chobanian & Avedisian School of Medicine, researchers found that patient rooms with windows were associated with an increased chance of developing delirium, compared to patient rooms without windows. .
Using electronic medical records, the researchers reviewed the association between admitting patients to an ICU room with or without windows and the presence of delirium. Delirium was observed in 21% (460/2,235) of patients in windowed rooms and in 16% (206/1,292) of patients in windowless rooms.
“Although the study results were ultimately unexpected given previous research suggesting the importance of circadian rhythm while in the hospital, our findings add to a growing body of evidence-based design literature regarding the importance of healthcare design to patient experience and outcomes,” explained corresponding author Diana Anderson, MD, FACHA, assistant professor of neurology at the school. She notes, due to the study design, these unexpected results are not causal and may reflect different patterns in which the clinical teams may assign some patients – who may be at increased risk of delirium – to different room layouts.
According to the authors, more research is needed on the specific qualities of windows that may affect health in order to better understand these results. “While this study adds to our understanding of the relationship between delirium and characteristics of the built environment, it is clear that further studies may provide further insight into understanding these findings. For example, the view from the window may be towards a nearby landscape or building. Context may be important in interpreting these results, or perhaps another aspect of the room such as light or sound that we may to consider in our next investigation,” says Anderson.
These results appear online in the journal Critical Care Medicine.
This work was supported by an internal Mass. General Brigham Chief Academic Officer Pilot Grant. In addition, Jacobs Architecture and Engineering supported Dr. Anderson.