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Delirium Variability is Influenced by the Sound Environment (DEVISE Study): How Changes in the Intensive Care Unit soundscape affect delirium incidence

Authors
  • Sangari, Ayush1
  • Emhardt, Elizabeth A.2
  • Salas, Barbara3
  • Avery, Andrew4
  • Freundlich, Robert E.2, 5
  • Fabbri, Daniel5
  • Shotwell, Matthew S.6
  • Schlesinger, Joseph J.2
  • 1 Vanderbilt University, 2301 Vanderbilt Place, PMB 351679, Nashville, TN, 37235, USA , Nashville (United States)
  • 2 Vanderbilt University Medical Center, 1211 21st Avenue South, MAB 422, Nashville, TN, 37212, USA , Nashville (United States)
  • 3 Freeman Hospital, Freeman Road, High Heaton, Newcastle-upon-Tyne, Tyne and Wear, NE7 7DN, UK , Tyne and Wear (United Kingdom)
  • 4 Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN, 37212, USA , Nashville (United States)
  • 5 Vanderbilt University Medical Center, 2525 West End Avenue, Suite 1475, Nashville, TN, 37203, USA , Nashville (United States)
  • 6 Vanderbilt University Medical Center, 2525 West End Avenue, Suite 1100, Nashville, TN, 37203, USA , Nashville (United States)
Type
Published Article
Journal
Journal of Medical Systems
Publisher
Springer-Verlag
Publication Date
Jun 25, 2021
Volume
45
Issue
8
Identifiers
DOI: 10.1007/s10916-021-01752-5
Source
Springer Nature
Keywords
Disciplines
  • Image & Signal Processing
License
Yellow

Abstract

Quantitative data on the sensory environment of intensive care unit (ICU) patients and its potential link to increased risk of delirium is limited. We examined whether higher average sound and light levels in ICU environments are associated with delirium incidence. Over 111 million sound and light measurements from 143 patient stays in the surgical and trauma ICUs were collected using Quietyme® (Neshkoro, Wisconsin) sensors from May to July 2018 and analyzed. Sensory data were grouped into time of day, then normalized against their ICU environments, with Confusion Assessment Method (CAM-ICU) scores measured each shift. We then performed logistic regression analysis, adjusting for possible confounding variables. Lower morning sound averages (8 am-12 pm) (OR = 0.835, 95% OR CI = [0.746, 0.934], p = 0.002) and higher daytime sound averages (12 pm–6 pm) (OR = 1.157, 95% OR CI = [1.036, 1.292], p = 0.011) were associated with an increased odds of delirium incidence, while nighttime sound averages (10 pm-8 am) (OR = 0.990, 95% OR CI = [0.804, 1.221], p = 0.928) and the ICU light environment did not show statistical significance. Our results suggest an association between the ICU soundscape and the odds of developing delirium. This creates a future paradigm for studies of the ICU soundscape and lightscape.

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