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The Adverse Effects of Physical Restraint Use among Older Adult Patients Admitted to the Internal Medicine Wards: A Hospital-Based Retrospective Cohort Study

  • Published:
The journal of nutrition, health & aging

Abstract

Objectives

To evaluate the negative effect of physical restraint use on the hospital outcomes of older patients.

Design

A retrospective cohort study.

Setting

Internal medicine wards of a tertiary medical center in Taiwan.

Participants

Subjects aged 65 years and over who were admitted during April to Dec 2017 were recruited for study.

Measurements

Demographic data, geriatric assessments (polypharmacy, visual impairment, hearing impairment, activities of daily living before and after admission, risk of pressure sores, change in consciousness level, mood condition, history of falls in the previous year, risk of malnutrition and pain) and hospital conditions (admission route, department of admission, length of hospital stay and mortality) were collected for analysis.

Results

Overall, 4,352 participants (mean age 78.7±8.7 years, 60.2% = male) were enrolled and 8.3% had physical restraint. Results of multivariate logistic regression showed that subjects with physical restraints were at greater risk of functional decline (adjusted odds ratio 2.136, 95% confidence interval 1.322–3.451, p=0.002), longer hospital stays (adjusted odds ratio 5.360, 95% confidence interval 3.627–7.923, p<0.001) and mortality (adjusted odds ratio 4.472, 95% confidence interval 2.794–7.160, p<0.001) after adjustment for covariates.

Conclusion

The use of physical restraints during hospitalization increased the risk of adverse hospital outcomes, such as functional decline, longer length of hospital stay and mortality.

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Author information

Authors and Affiliations

  1. Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, 386, Ta-Chung 1st RD. Zuoying District 813, Kaohsiung, Taiwan

    M.-Y. Chou, Y.-H. Hsu, Y.-C. Wang, C.-S. Chu, M.-C. Liao, Chih-Kuang Liang & Y.-T. Lin

  2. Aging and Health Research Center, National Yang Ming University, Taipei, Taiwan

    M.-Y. Chou, Chih-Kuang Liang & L.-K. Chen

  3. Department of Geriatric Medicine, National Yang Ming University School of Medicine, Taipei, Taiwan

    M.-Y. Chou, Chih-Kuang Liang & L.-K. Chen

  4. Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan

    C.-S. Chu

  5. Division of Neurology, Department of Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan

    Chih-Kuang Liang & Y.-T. Lin

  6. Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan

    L.-K. Chen

Authors
  1. M.-Y. Chou
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  2. Y.-H. Hsu
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  6. Chih-Kuang Liang
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Contributions

Author contributions statements: Ming-Yueh Chou wrote the main manuscript text, Ying-Hsin Hsu, Yu-Chun Wang, Che-Sheng Chu and Mei-Chen Liao did the main statistics, and Chih-Kuang Liang, Liang-Kung Chen and Yu-Te Lin designed the study and did the critical reviews for whole manuscript. Ming-Yueh Chou interpreted the data and was a major contributor to writing the manuscript.

Corresponding author

Correspondence to Chih-Kuang Liang.

Ethics declarations

Conflicts of Interest: All authors have no conflicts of interest to declare.

Ethical standards: The prospectively observational study was approved by the ethics committee of Kaohsiung Veterans General Hospital. The study was waived the requirement for patient consent. (VGHKS 17-CT1-08).

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Chou, MY., Hsu, YH., Wang, YC. et al. The Adverse Effects of Physical Restraint Use among Older Adult Patients Admitted to the Internal Medicine Wards: A Hospital-Based Retrospective Cohort Study. J Nutr Health Aging 24, 160–165 (2020). https://doi.org/10.1007/s12603-019-1306-7

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  • DOI: https://doi.org/10.1007/s12603-019-1306-7

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