The Adverse Effects of Physical Restraint Use among Older Adult Patients Admitted to the Internal Medicine Wards: A Hospital-Based Retrospective Cohort Study
The Adverse Effects of Physical Restraint Use among Older Adult Patients Admitted to the Internal Medicine Wards: A Hospital-Based Retrospective Cohort Study
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DOI：
10.1007/s12603-019-1306-7
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发表时间：
2020-02-01
影响因子：
5.8
通讯作者：
Lin, Y. -T.
中科院分区：
文献类型：
--
作者：
Chou, M. -Y.;Hsu, Y. -H.;Lin, Y. -T.
目的 评估身体约束的使用对老年患者医院结局的负面影响。设计一项回顾性队列研究。台湾三级医疗中心内科病房设置。研究对象招募2017年4月至12月期间入学的65岁及以上受试者进行研究。测量收集人口统计数据、老年评估（多药用药、视力障碍、听力障碍、入院前后日常生活活动、压疮风险、意识水平变化、情绪状况、前一年跌倒史、营养不良和疼痛风险）和医院情况（入院途径、入院科室、住院时间和死亡率）进行分析。结果 总体而言，共有 4,352 名参与者（平均年龄 78.7 +/- 8.7 岁，60.2% = 男性）参与其中，其中 8.3% 受到身体约束。多变量逻辑回归结果显示，受到身体约束的受试者功能下降的风险更大（调整后比值比 2.136，95% 置信区间 1.322-3.451，p=0.002），住院时间更长（调整后比值比 5.360，95% 置信区间 3.627-7.923，p=0.002）。
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