Comparing Delirium Incidence and Length of Stay in Cardiovascular Procedures Before and After Coronavirus Disease 2019 Family Visitation Restrictions: A Single-Center Cohort Study

BACKGROUND: The impact of visitation restrictions due to the coronavirus disease (COVID-19) pandemic remains uncertain. This study examined delirium incidence and length of hospital stay of patients who underwent coronary artery bypass grafting, percutaneous coronary intervention, and transcatheter aortic valve implantation before and after visitation restrictions. METHODS: The visitation restriction group (RG) included patients admitted and discharged between April 1, 2020, and March 31, 2022, whereas the non-restriction group (Non-RG) included those between April 1, 2018, and March 31, 2020. A chi-square test and sensitivity analysis were conducted to compare delirium incidence. The Mann-Whitney U test was used to compare the median length of stay. We conducted a multivariate logistic regression analysis to examine the association between delirium incidence and visitation restrictions and performed a subgroup analysis. RESULTS: There was no significant difference in delirium incidence between Non-RG and RG (0.7% vs. 2.1%, P=0.083), as supported by the sensitivity analysis (3.3% vs. 2.1%, P=0.29). The length of stay significantly differed between Non-RG and RG (14 vs. 16 days, P=0.021). The odds ratios for delirium incidence, visitation restriction, emergency admission, and daily living level II were 2.46 (1.11-5.84), 3.65 (1.65-8.31), and 18.2 (3.45- 78.8), respectively. In the subgroup analysis, increase in sleep medications and discharge support were observed in high-risk patients. CONCLUSION: The analyses revealed no significant differences in delirium incidence between Non-RG and RG; however, the length of stay slightly increased. Delirium support and strategies for patient well-being during a pandemic are warranted.