Mechanical restraints on the medical wards: are protective devices safe?
We prospectively identified 102 mechanically restrained hospital patients and determined their hospital course. The cohort was elderly, cognitively impaired with multiple chronic diseases. The in-hospital mortality was 21 percent. Nosocomial infection developed in 12 percent and new pressure sores in 22 percent. Prolonged use of restraints (greater than 4 days) was the strongest independent predictor of nosocomial infection (relative risk 1.8, 95% CI = 1.2, 2.8) and new pressure sores (RR 1.4, 95% CI = 1.1, 1.8) as determined by multiple logistic regression analysis. Patients placed in mechanical restraints for longer than four days experience frequent morbid events and should be monitored carefully.
Lofgren
R P
RP
University of Pittsburgh, PA.
MacPherson
D S
DS
Granieri
R
R
Myllenbeck
S
S
Sprafka
J M
JM
D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders; D015331:Cohort Studies; D003428:Cross Infection / Q000209:etiology*; D003625:Data Collection; D004869:Equipment Safety / Q000706:statistics & numerical data; D006268:Health Facilities; D006801:Humans; D008297:Male; D008875:Middle Aged; D010362:Patients' Rooms; D010414:Pennsylvania; D003668:Pressure Ulcer / Q000209:etiology*; D011446:Prospective Studies; D012044:Regression Analysis; D012149:Restraint, Physical / Q000009:adverse effects*; D012307:Risk Factors; D013997:Time Factors