VR-based prevention of delirium in patients with stroke

Introduction. Delirium’s incidence ranges from 15% to 80% and associated with prolonged intensive care unit (ICU) stay, increased overall hospital length of stay, and higher mortality. In a previously published article we noted a trend toward a reduction in the incidence of delirium with the use of VR. The results of the subsequent study allowed for a more comprehensive assessment of the impact of VR on the incidence, severity and duration of delirium.

Aim. To evaluate the effect of virtual reality on the incidence, severity, and duration of delirium in patients with acute stroke admitted to the ICU.

Materials and methods. A randomized controlled trial was conducted at Veresaev City Clinical Hospital, Moscow. Patients with acute stroke admitted to the ICU who met the inclusion criteria (n = 219) were randomized into two groups. In Group 1, delirium prevention was performed according to the ABCDEF bundle. In Group 2, VR stimulation using dedicated headsets was administered in addition to the ABCDEF bundle. The severity of delirium was assessed using the DRS-R-98 scale.

Results. Delirium developed in 27 patients (23.9%) in the standard therapy group and in 10.4% of patients in the VR group; the difference was statistically significant. Delirium was more severe in the control group compared to the VR group (p < 0.05). The median duration of delirium was 48 hours in Group 1 and 24 hours in Group 2, indicating the effectiveness of VR in reducing delirium duration. VR was well tolerated, and all patients in Group 2 completed the full course of VR sessions.

Conclusions. Virtual reality may be considered an additional non-pharmacological tool for delirium prevention in patients with acute stroke.

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