Association between the duration of physical restraint and pulmonary embolism in psychiatric patients: A nested...

Pulmonary embolism is the most life-threatening adverse event following physical restraint. However, little is known about the associaton between the duration of physical restraint and pulmonary embolism in psychiatric patients.

The purpose of this study is to evaluate whether more total days of physical restraint is associated with a higher risk of pulmonary embolism.

This is a retrospective nested case-control study using a Japanese nationwide administrative inpatient database. We identified patients who were admitted to psychiatric departments from July 2010 to March 2017. One-to-four case-control matching was performed with patients with and without pulmonary embolism. We performed multivariable conditional logistic regression analyses to assess the odds ratios of total days of physical restraint regarding pulmonary embolism.

We identified 223,285 eligible psychiatric patients; 132 (0.059%) patients developed pulmonary embolism during hospitalization. Overall, 13.2% of the psychiatric patients experienced physical restraint for at least 1 day. More total days of physical restraint was significantly associated with a higher risk of pulmonary embolism.

Longer exposure to physical restraint may increase the risk of pulmonary embolism in psychiatric patients.