• Samiha Mohsen, Stephana J Moss, Filipe Lucini, Karla D Krewulak, Henry T Stelfox, Daniel J Niven, Khara M Sauro, and Kirsten M Fiest.
• Department of Critical Care Medicine, Alberta Health Services & University of Calgary, Calgary, AB, Canada.
• Crit. Care Med. 2022 Nov 1; 50 (11): 162816371628-1637.

ObjectiveTo assess the effect of family presence on the prevalence and duration of delirium in adults admitted to an ICU.DesignRetrospective cohort study.SettingMedical-surgical ICUs in Alberta, AB, Canada.PatientsA population of 25,537 unique patients admitted at least once to an Alberta ICU.MethodsWe obtained electronic health records of consecutive adults (≥ 18 yr) admitted to one of 14 medical-surgical ICU in Alberta, Canada, from January 1, 2014, to December 30, 2018. Family presence was quantified using a validated algorithm and categorized as: 1) physical presence in ICU, 2) telephone call only, and 3) no presence (reference group). Delirium was measured using the Intensive Care Delirium Screening Checklist (ICDSC) and defined as an ICDSC greater than or equal to 4. Multivariable mixed-effects logistic and linear regression were used to evaluate the association between family presence and prevalence (binary) and duration (d) of delirium, respectively.InterventionsNone.Measurements And Main ResultsThe association between family presence and delirium prevalence differed according to admission type and admission Glasgow Coma Scale (GCS). Among medical and emergency surgical patients irrespective of admission GCS, physical presence of family was not significantly associated with the prevalence of delirium. In elective surgical patients, physical presence of family was associated with decreased prevalence of delirium in patients with intact Glasgow Coma Scale (GCS = 15; adjusted odds ratio, 0.60; 95% CI, 0.39-0.97; p = 0.02). Physical presence of family (adjusted mean difference [AMD] -1.87 d; 95% CI, -2.01 to -1.81; p < 0.001) and telephone calls (AMD -1.41 d; 95% CI, -1.52 to -1.31; p < 0.001) were associated with decreased duration of delirium in all patients.ConclusionsThe effects of family presence on delirium are complex and dependent on type of visitation, reason for ICU admission, and brain function on ICU admission.Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine and Wolters Kluwer Health, Inc.

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