Photo Credit: Vadym Terelyuk

This retrospective study at an urban Level I academic trauma hospital’s emergency department over five years identified several factors associated with an increased risk of using physical restraints, with drug or alcohol intoxication having the highest adjusted odds ratio, while the American Indian race was linked to higher chances of restraint application, and individuals of Hispanic ethnicity and Black race had lower probabilities of restraint use.

The following is a summary of “Factors Associated With Physical Restraint in an Urban Emergency Department” published in the February 2024  issue of Emergency Medicine by Robinson, et al.

For a study, researchers sought to identify the patient characteristics linked to using physical restraints in their emergency department (ED). A Level I academic trauma hospital’s urban emergency department (ED) was the subject of this retrospective examination of patient contacts. 

During five years, beginning in 2017, they included emergency department interactions of adult patients who were at least 18 years old. Through the use of a generalized estimating equation model, they conducted an analysis of the independent connection between the application of restraints during an interaction. There were a total of 464,031 contacts in the emergency department throughout the time period, involving 162,244 distinct patients. Of them, 34,798 (7.5%) included the use of restraints, which included 18,166 distinct patients. It was shown that there were many factors that were connected with an increased risk of using restraints during an interaction. With an adjusted odds ratio (aOR) of 8.29 with a 95% confidence interval (CI) ranging from 7.94 to 8.65, the variable that had the greatest odds ratio was intoxication with drugs or alcohol. 

Compared to the White race’s reference value, the American Indian race was linked with higher chances of restraint application (aOR 1.42; 95% CI 1.31 to 1.54). Other races were not associated with this finding. The restraint application probabilities were lower for individuals of Hispanic ethnicity (aOR 0.42; 95% CI 0.37 to 0.48) and Black race (aOR 0.58; 95% CI 0.55 to 0.61). Intoxication with drugs and alcohol was shown to be the most closely linked pattern with constraint. This research does not replicate previous results addressing other racial differences in restraint; rather, encounters in which the patient was an American had a greater likelihood of the patient being restrained.

Source: sciencedirect.com/science/article/abs/pii/S0196064423006625