Evidence map›Paper›PMID 39390151›Full record

ArticleJournal of general internal medicine2025

Physical Restraint Use in Hospitalized Patients: A Study of Routinely Collected Health Records Data.

James Luccarelli, Tsu K Gan, Sara B Golas, Poorvi Sriraman, Colleen K Snydeman, Chana A Sacks, Thomas H McCoy

Abstract read
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In one paragraph

Article in Journal of general internal medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

James LuccarelliMassachusetts General Hospital, 32 Fruit Street, Yawkey 6A, Boston, MA, 02114, USA. jluccarelli@mgb.org.ORCID 0000-0002-1606-3917
Tsu K GanMassachusetts General Hospital, 32 Fruit Street, Yawkey 6A, Boston, MA, 02114, USA.
Sara B GolasMassachusetts General Hospital, 32 Fruit Street, Yawkey 6A, Boston, MA, 02114, USA.
Poorvi SriramanUniversity of Massachusetts Amherst, Amherst, MA, USA.
Colleen K SnydemanMassachusetts General Hospital, 32 Fruit Street, Yawkey 6A, Boston, MA, 02114, USA.
Chana A SacksMassachusetts General Hospital, 32 Fruit Street, Yawkey 6A, Boston, MA, 02114, USA.
Thomas H McCoyMassachusetts General Hospital, 32 Fruit Street, Yawkey 6A, Boston, MA, 02114, USA.

Funding

Translational Neuroscience Training for CliniciansT32MH112485 · NIMH · MASSACHUSETTS GENERAL HOSPITAL · PI BUCKNER, RANDY L, ROFFMAN, JOSHUA LAWRENCE · 2018 to 2022
$1.7M
NIMH NIH HHS T32 MH112485NIMH NIH HHS T32MH112485
6 · The paper itself

Abstract

backgroundThe use of restraints in hospitalized patients is associated with physical and psychological adversity for patients and staff. The minimization of restraint use is a key goal in the hospital setting. Reaching this goal requires an accurate assessment of existing patterns of use across clinical settings.

objectiveThis study reports the rate of physical restraints among patients hospitalized within a multi-entity healthcare network along with stratification by care context, diagnostic, and demographic factors, and examines the sensitivity and specificity of ICD-10 code Z78.1 "physical restraint status" for defining physical restraints relative to electronic health record (EHR) documentation.

designThe EHR was used for a retrospective analysis of all adults hospitalized between 2017 and 2022.

participantsHospitalized adults. MAIN MEASURES: Patient demographics, structured diagnostic information, care area, length of stay, and in-hospital mortality, Z78.1 coding for physical restraints, restraint documentation in orders and flowsheets. KEY

resultsAmong 742,607 hospitalizations, 6.3% (n=47,041) involved the use of physical restraint based on coding or EHR documentation. Treatment in the intensive care unit (ICU) included restraint in 39% of encounters whereas treatment outside the ICU included restraint use in 1.3% of encounters. Besides critical illness, demographic factors including increasing age (adjusted odds ratio (aOR)=1.21 [1.19-1.23]), male gender (aOR=1.56, [1.52-1.60]), unknown race (aOR=1.27 [1.19-1.35]), and preferred language other than English (aOR=1.24, [1.18-1.29]) were associated with higher odds of restraint utilization. As compared to EHR orders or documentation of restraint, the ICD-10 code for physical restraint had a sensitivity of 1.5% and a specificity of 99.99%.

conclusionAmong adults admitted to acute care hospitals, clinical, demographic, and operational factors were associated with increased odds of restraint, with care in the ICU associated with greatly increased odds of restraint. Research into restraint utilization using coded administrative claims data is likely limited by the sensitivity of physical restraint coding.

Indexed as

Electronic Health RecordsHospitalizationRestraint, PhysicalAdultAgedAged, 80 and overFemaleHospital MortalityHumansMaleMiddle AgedRetrospective StudiesCohort studiesDemographyPhysicalRestraint

Identifiers

PMID39390151
PMCPMC12053693

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