Association of ICU Room Characteristics With Mortality and Length of Stay

Objectives: In addition to medical considerations, economic factors are increasingly influencing hospital planning. While guidelines suggest ICU room design and layout likely affect outcomes, data supporting current recommendations are scarce. The aim of this study was to investigate the association of shared rooms vs. single rooms, high vs. low visibility, and distances of nurses’ and doctors’ charting areas to patients’ rooms with mortality and length of stay in a large, mixed-discipline cohort. Design: Retrospective observational cohort study. Setting: Four ICUs at the University Medical Center Mannheim, Germany. Patients: Critically ill adults with ICU admission between January 2019 and May 2022 for at least 24 hours. Interventions: None. Measurements and Main Results: Associations of the index variables with in-hospital mortality and ICU length of stay were assessed by multivariate regression, adjusting for biological sex, Simplified Acute Physiology Score II, need for vasopressors, need for ventilation, and medical vs. surgical admission. Five thousand two hundred ninety-three patient stays with a mortality rate of 18% and a mean length of stay of 6.3 ± 9.2 days in survivors were eligible for this analysis. In the overall cohort, none of the index variables showed associations with mortality. Patients admitted to single rooms showed a mean length of stay increase by 0.81 days (95% CI, 0.04–1.57 d; p = 0.039) compared with shared rooms with up to three beds. Conclusions: In this mixed cohort of medical and surgical ICUs, neither single rooms compared with shared rooms, high-visibility rooms compared with low-visibility rooms, nor distances to nurses’ or doctors’ charting areas were associated with mortality. The observed increase in length of stay associated with single room admission highlights the need to balance privacy and infection control benefits with potential implications for ICU capacity and operational efficiency.