{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T09:06:04Z","timestamp":1783933564341,"version":"3.55.0"},"reference-count":35,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100007452","name":"Wu Jieping Medical Foundation","doi-asserted-by":"publisher","award":["320.6750.2024-05-8"],"award-info":[{"award-number":["320.6750.2024-05-8"]}],"id":[{"id":"10.13039\/100007452","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Advantageous Discipline Construction Project of Guizhou Provincial Health Commission in 2025"},{"name":"Beijing Jishuitan Hospital Guizhou Hospital Youth Innovation Fund","award":["YQNCX[2023]18"],"award-info":[{"award-number":["YQNCX[2023]18"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Int Med Res"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate whether flexible family visitation reduces postoperative delirium in older patients admitted to an orthopedic intensive care unit and to explore whether its effects vary by surgical type.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This single-center, parallel-group randomized controlled trial enrolled patients aged \u226560 years who were admitted to the orthopedic intensive care unit within 24\u2009h following orthopedic surgery. Participants were randomized to daytime flexible family visitation or routine restricted visitation. Delirium during intensive care unit stay was assessed daily using the Confusion Assessment Method for the Intensive Care Unit and the Intensive Care Delirium Screening Checklist. Secondary outcomes included sedative use, hospital-acquired infection, length of stay, and hospitalization costs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 405 participants, flexible visitation reduced delirium incidence (29.5% vs 44.4%,\n                      <jats:italic toggle=\"yes\">P\u2009<\/jats:italic>\n                      =\n                      <jats:italic toggle=\"yes\">\u2009<\/jats:italic>\n                      0.002) and sedative use (32.0% vs 44.9%,\n                      <jats:italic toggle=\"yes\">P\u2009<\/jats:italic>\n                      =\n                      <jats:italic toggle=\"yes\">\u2009<\/jats:italic>\n                      0.008). Patients undergoing cervical spine surgery showed the greatest benefit (36.5% vs 57.6%,\n                      <jats:italic toggle=\"yes\">P\u2009<\/jats:italic>\n                      =\n                      <jats:italic toggle=\"yes\">\u2009<\/jats:italic>\n                      0.026). Flexible visitation did not increase hospital-acquired infections (3.5% vs 3.9%,\n                      <jats:italic toggle=\"yes\">P\u2009<\/jats:italic>\n                      =\n                      <jats:italic toggle=\"yes\">\u2009<\/jats:italic>\n                      0.916) or length of stay (median, 16 days in both groups,\n                      <jats:italic toggle=\"yes\">P\u2009<\/jats:italic>\n                      =\n                      <jats:italic toggle=\"yes\">\u2009<\/jats:italic>\n                      0.367) but lowered total hospitalization costs (\n                      <jats:italic toggle=\"yes\">P\u2009<\/jats:italic>\n                      &lt;\n                      <jats:italic toggle=\"yes\">\u2009<\/jats:italic>\n                      0.001). Flexible visitation may improve outcomes and reduce costs in high-risk orthopedic intensive care unit patients.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Flexible family visitation was associated with lower delirium burden, reduced sedative exposure, and lower hospitalization costs in older orthopedic intensive care unit patients, without increasing infection or prolonging hospitalization. The benefit appeared most pronounced after cervical spine surgery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03000605261452566","type":"journal-article","created":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T05:07:32Z","timestamp":1783746452000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Flexible family visitation and postoperative delirium in an orthopedic intensive care unit: A randomized trial examining surgical-type heterogeneity and cost outcomes"],"prefix":"10.1177","volume":"54","author":[{"given":"Zhenyang","family":"Ke","sequence":"first","affiliation":[{"name":"Beijing Jishuitan Hospital Guizhou Hospital, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tianhui","family":"He","sequence":"additional","affiliation":[{"name":"Beijing Jishuitan Hospital Guizhou Hospital, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ping","family":"Luo","sequence":"additional","affiliation":[{"name":"Beijing Jishuitan Hospital Guizhou Hospital, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-9757-5623","authenticated-orcid":false,"given":"Wanwei","family":"Jiang","sequence":"additional","affiliation":[{"name":"Beijing Jishuitan Hospital Guizhou Hospital, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,10]]},"reference":[{"key":"e_1_3_6_2_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.202002-0320OC"},{"key":"e_1_3_6_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000002873"},{"key":"e_1_3_6_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000005276"},{"key":"e_1_3_6_5_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-020-66276-3"},{"key":"e_1_3_6_6_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-023-27829-4"},{"key":"e_1_3_6_7_2","doi-asserted-by":"publisher","DOI":"10.3389\/fnagi.2022.960364"},{"key":"e_1_3_6_8_2","doi-asserted-by":"publisher","DOI":"10.1177\/00469580251368654"},{"key":"e_1_3_6_9_2","doi-asserted-by":"publisher","DOI":"10.62675\/2965-2774.20250099"},{"key":"e_1_3_6_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.iccn.2025.103976"},{"key":"e_1_3_6_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2010.11.002"},{"key":"e_1_3_6_12_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2019.8766"},{"key":"e_1_3_6_13_2","doi-asserted-by":"publisher","DOI":"10.1177\/00368504231165663"},{"key":"e_1_3_6_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jointm.2024.12.009"},{"key":"e_1_3_6_15_2","doi-asserted-by":"crossref","first-page":"e081123","DOI":"10.1136\/bmj-2024-081123","article-title":"CONSORT 2025 statement: updated guideline for reporting randomised trials","volume":"389","author":"Hopewell S","year":"2025","unstructured":"Hopewell S, Chan AW, Collins GS, et\u00a0al. 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