Association of ICU Room Characteristics With Mortality and Length of Stay
8 affiliations
- 1Department of Cardiology, Haemostaseology and Medical Intensive Care, Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany.
- 2European Center for AngioScience (ECAS), German Centre for Cardiovascular Research (DZHK) partner site Heidelberg/Mannheim, and Centre for Cardiovascular Acute Medicine Mannheim (ZKAM), Medical Centre Mannheim and Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany.
- 3Helmholtz-Institute for Translational AngioCardioScience (HI-TAC) of the Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC) at Heidelberg University, Heidelberg, Germany.
- 4Department of Radiation Oncology, Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany.
- 5DKFZ Hector Cancer Institute, Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany.
- 6Mannheim Institute for Intelligent Systems in Medicine (MIISM), Heidelberg University, Heidelberg, Germany.
- 7HMS Analytical Software GmbH, Heidelberg, Germany.
- 8Department of Anesthesiology and Critical Care Medicine, University Medical Center Mannheim, Medical Faculty Mannheim of the University of Heidelberg, Mannheim, Germany.
Abstract
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.
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BibTeX
@article{lindner2026association,
title = {{Association of ICU Room Characteristics With Mortality and Length of Stay}},
author = {Simon Lindner and Markward Britsch and Daniel Duerschmied and Alice Marguerite Conrad and Joerg Krebs and Tobias Becher and Simone Britsch},
journal = {Critical Care Medicine},
year = {2026},
month = aug,
doi = {10.1097/ccm.0000000000007305},
url = {https://doi.org/10.1097/ccm.0000000000007305},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Association of ICU Room Characteristics With Mortality and Length of Stay
AU - Simon Lindner
AU - Markward Britsch
AU - Daniel Duerschmied
AU - Alice Marguerite Conrad
AU - Joerg Krebs
AU - Tobias Becher
AU - Simone Britsch
PY - 2026
DA - 2026/08/18
JO - Critical Care Medicine
DO - 10.1097/ccm.0000000000007305
UR - https://doi.org/10.1097/ccm.0000000000007305
AB - 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.
SN - 0090-3493
SN - 1530-0293
ER -