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. 2023 Sep;71(9):2886-2892.
doi: 10.1111/jgs.18422. Epub 2023 May 26.

Outcomes among hospitalized patients with dementia and behavioral disturbances when physical restraints are introduced

Amteshwar Singh  1 , Ishaan Gupta  1 , Scott Mitchell Wright  1 , Che Matthew Harris  1
Affiliations

Outcomes among hospitalized patients with dementia and behavioral disturbances when physical restraints are introduced

Amteshwar Singh et al. J Am Geriatr Soc. 2023 Sep.

Abstract

Background: Physical restraint use among patients hospitalized with dementia and behavioral disturbances has not been studied nationally in the United States.

Methods: National Inpatient Sample database years 2016 through 2020 were used to compare physically restrained and unrestrained patients with dementia and behavioral disturbances. Multivariable regression analyses were used to assess patient outcomes.

Results: There were 991,605 patients coded for dementia with behavioral disturbances. Among these, physical restraints were used with 64,390 (6.5%) and not with 927,215 (93.5%). Patients in the restrained group were younger (mean age ± standard error: 78.7 ± 0.25 vs. 79.9 ± 0.34 ; p < 0.01) and more often male (59.0% vs. 45.8%; p < 0.01) compared to the unrestrained group. A higher proportion of Black patients were in the restrained group (15.2% vs. 11.8%; p < 0.01). Larger hospitals also made up a more significant proportion of restrained versus unrestrained patients (53.3% vs. 45.1%; p < 0.01). Those with physical restraints had longer lengths of stays (adjusted mean difference [aMD] = 2.6 days CI [2.2-3.0]; p < 0.01) and higher total hospital charges (aMD = $13,150 CI [10,827-15,472]; p < 0.01). There were similar adjusted odds for in-hospital mortality (adjusted odds ratio [aOR] = 1.0 [CI 0.95-1.1]; p = 0.28) and lower odds of being discharged to home after hospitalization (aOR = 0.74 [0.70-0.79]; <0.01) for patients with physical restraints compared to those without.

Conclusion: Among patients hospitalized with dementia and behavioral disturbances, those with physical restraints had greater hospital resource utilization outcomes. Attempts to limit physical restraint use whenever possible may improve outcomes in this vulnerable population.

Keywords: dementia; hospitalization; physical restraints.

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References

REFERENCES

    1. Fang Z, Owens PL. Changes in Hospitalizations and In-Hospital Deaths for Adults Aged 65 Years and Older in the Initial Period of the COVID-19 Pandemic (April-December 2020), 29 States STATISTICAL BRIEF #293. 2020.
    1. Sakata N, Okumura Y, Fushimi K, Nakanishi M, Ogawa A. Dementia and risk of 30-day readmission in older adults after discharge from acute care hospitals. J Am Geriatr Soc. 2018;66(5):871-878.
    1. Tropea J, LoGiudice D, Liew D, Gorelik A, Brand C. Poorer outcomes and greater healthcare costs for hospitalized older people with dementia and delirium: a retrospective cohort study. Int J Geriatr Psychiatry. 2017;32(5):539-547.
    1. Jencks SF, Williams MV, Coleman EA. Rehospitalizations among patients in the Medicare fee-for-service program. N Engl J Med. 2009;360(14):1418-1428.
    1. Greysen SR, Cenzer IS, Auerbach AD, Covinsky KE. Functional impairment and hospital readmission in Medicare seniors. JAMA Intern Med. 2015;175(4):559-565.

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