Lack of family visitation in ICU can have long-term consequences on ICU patients post-discharge. Efect of family visitation on the incidence of patient psychiatric disorders is unknown.
What is the association between family visitation in the ICU and incidence of psychiatric outcomes in ICU patients 1-year post-hospital discharge?
Population-based retrospective cohort of adult patients admitted to ICU from January 1, 2014 to May 30, 2017 surviving to hospital discharge with ICU length of stay ≥3 days. To be eligible patients needed to have minimum 5-years administrative data prior to ICU admission and minimum 1-year follow-up data post-hospital discharge. An internally validated algorithm that interpreted natural language in health records determined patients with or without in-person family (i.e., relatives, friends) visitation during ICU stay. Primary outcome was risk of an incidence of psychiatric disorder (composite outcome) including anxiety, depressive, trauma- and stressor-related, psychotic, and substance use disorders, identified using coding algorithms for administrative databases. Propensity scores were used in inverse probability weighted logistic regression models and average treatment effects were converted to risk ratios (RR) with 95% confidence intervals (95%CIs). Secondary outcomes were incidences of diagnoses by type of psychiatric disorder.
We included 14,344 patients with (96%, n=13,771) and without (4.0%, n=573) in-person family visitation who survived hospital discharge. Over one-third of patients were diagnosed with any psychiatric disorder within 1-year post-discharge (34.9%, 95%CI: 34.1%-35.6%). Patients were most often diagnosed with anxiety disorders (17.5%, 95%CI: 16.9%-18.1%) and depressive disorders (17.2%, 95%CI: 16.6%-17.9%). After inverse probability weighting of 13,731 patients, in-person family visitation associated with lower risk of being diagnosed with any incident psychiatric disorder within 1-year post-discharge (RR 0.79, 95%CI: 0.68-0.92).
ICU family visitation is associated with decreased risk for psychiatric disorders in critically ill patients up to 1-year after hospital discharge.

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