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. 2021 Aug;11(8):e2276.
doi: 10.1002/brb3.2276. Epub 2021 Aug 2.

Risk factors for inducing violence in patients with delirium

Masako Tachibana  1   2 , Toshiya Inada  2   3 , Masaru Ichida  1 , Norio Ozaki  2
Affiliations

Risk factors for inducing violence in patients with delirium

Masako Tachibana et al. Brain Behav. 2021 Aug.

Abstract

Background: Violence in patients with delirium may occur suddenly and unpredictably in a fluctuating state of consciousness. Although various factors are involved, appropriate assessment and early response to factors related to violence in delirium are expected to prevent dangerous and distressing acts of violence against patients, their families and medical staff, and minimize the use of physical restraint and excessive drug sedation.

Methods: Subjects were 601 delirium cases referred to the department of psychiatry over the course of 5 years at a general hospital. The demographic, clinical, and pharmacological variables of patients with violence (n = 189) were compared with those of patients without violence (n = 412). Logistic regression analysis was applied to determine whether any specific individual factors were associated with violence.

Results: Current smoker status (p < .0005), older age (p < .0005), male gender (p = .004), and use of intensive care units (p = .043) were identified as factors associated with violence in patients with delirium.

Conclusions: Screening tools for violence in patients with delirium and adequate management may assist in better outcomes for patients and medical staff. Further research should evaluate the usefulness of nicotine replacement treatment for the prevention of violence during nicotine withdrawal, including whether it is safe for elderly inpatients with a high incidence of delirium in clinical practice.

Keywords: ICU; delirium; male; risk factors; smoking; violence.

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Conflict of interest statement

Dr. N. Ozaki has received research support or speakers’ honoraria from, or has served as a consultant to, Sumitomo Dainippon, Otsuka, DAIICHI SANKYO, Tsumura, Nihon Medi‐Physics, Pfizer, KAITEKI, Eli Lilly, Mochida, Eisai, Takeda, Novartis, Astellas, MSD, Meiji Seika Pharma, Janssen, Mitsubishi Tanabe, Kyowa, Taisho Pharma, EA Pharma, UCB, and Shionogi, outside the submitted work. Other authors declare no conflict of interest for the publication of this study.

References

    1. Almeida, T. M., Azevedo, L. C., Nose, P. M., Freitas, F. G., & Machado, F. R. (2016). Risk factors for agitation in critically ill patients. Revista Brasileira de Terapia Intensiva, 28(4), 413–419. 10.5935/0103-507X.20160074 - DOI - PMC - PubMed
    1. American Psychiatric Association . (2013). Diagnostic and statistical manual of mental disorder (5th ed.). American Psychiatric Publishing.
    1. Cipriani, G., Vedovello, M., Nuti, A., & Di Fiorino, M. (2011). Aggressive behavior in patients with dementia: Correlates and management. Geriatrics & Gerontology International, 11(4), 408–413. 10.1111/j.1447-0594.2011.00730.x - DOI - PubMed
    1. de Jong, B., Schuppers, A. S., Kruisdijk‐Gerritsen, A., Arbouw, M. E. L., van den Oever, H. L. A., & van Zanten, A. R. H. (2018). The safety and efficacy of nicotine replacement therapy in the intensive care unit: A randomised controlled pilot study. Annals of Intensive Care, 8(1), 70. 10.1186/s13613-018-0399-1 - DOI - PMC - PubMed
    1. Ideker, K., Todicheeney‐Mannes, D., & Kim, S. C. (2011). A confirmatory study of violence risk assessment tool (M55) and demographic predictors of patient violence. Journal of Advanced Nursing, 67(11), 2455–2462. 10.1111/j.1365-2648.2011.05667.x - DOI - PubMed

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