title: Prophylactic use of heparin for deep vein thrombosis in restrained psychiatric patients: a chart review.
abstract: OBJECTIVE
  Physical restraint sometimes causes deep vein thrombosis (DVT) and pulmonary embolism. Although unfractionated heparin (UFH) is used for the prophylaxis of DVT, its effectiveness remained unknown for restrained patients.
  
  
  METHODS
  We conducted a chart review of restrained inpatients at Sakuragaoka Memorial Hospital in Japan. Restrained patients received subcutaneous injection of UFH 5000 IU bid from December 2008 to September 2010 [heparin (+) period] while UFH was not used from December 2010 to September 2012 [heparin (-) period]. A Doppler ultrasound scanning was performed to examine the presence of DVT. The incidence of DVT was compared between the two periods by chi-square test. A multiple logistic regression model was used to examine effects of demographic and clinical characteristics on the incidence of DVT.
  
  
  RESULTS
  No significant difference was found in the incidence of DVT between the heparin (+) and (-) periods [11.8% (11/93) vs. 11.1% (13/117)]. Sedation [odds ratio (OR) = 3.78], physical comorbidities (OR = 6.29) and a longer duration of restraint (OR = 1.22) were associated with the incidence of DVT.
  
  
  CONCLUSIONS
  The use of UFH was not associated with any reduction in the incidence of DVT in restrained psychiatric patients.
authors: Department of Psychiatry, Sakuragaoka Memorial Hospital, Tokyo, Japan; Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan. Electronic address: t_ishi_2750@yahoo.co.jp.
authors: Takuto
authors: T
authors: Ishida
authors: Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan; Department of Psychiatry, Inokashira Hospital, Tokyo, Japan.
authors: Takefumi
authors: T
authors: Suzuki
authors: Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan; Department of Neuropsychiatry, Kyorin University School of Medicine, Tokyo, Japan.
authors: Koichiro
authors: K
authors: Watanabe
authors: Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan; Department of Psychiatry, Inokashira Hospital, Tokyo, Japan.
authors: Hitoshi
authors: H
authors: Sakurai
authors: Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan; Geriatric Mental Health Program, Centre for Addiction and Mental Health, Toronto, ON, Canada.
authors: Hiroyuki
authors: H
authors: Uchida
authors: Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan.
authors: Masaru
authors: M
authors: Mimura
mesh_terms: D000328:Adult; D000925:Anticoagulants / Q000008:administration & dosage / Q000494:pharmacology*; D015897:Comorbidity; D016292:Procedural Sedation / Q000009:adverse effects; D005260:Female; D006493:Heparin / Q000008:administration & dosage / Q000494:pharmacology*; D006778:Hospitals, Psychiatric; D006801:Humans; D007297:Inpatients; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000628:therapy*; D008875:Middle Aged; D012149:Restraint, Physical / Q000009:adverse effects*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000188:drug therapy* / Q000453:epidemiology / Q000209:etiology*
chemical_list: D000925:Anticoagulants; D006493:Heparin
keywords: Deep vein thrombosis; Heparin; Pulmonary embolism; Restraint; Sedation