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Characteristics of Patients Associated With Restraint Use at a Midwest Children's Hospital

Adrienne G DePorre1,2,3, Ingrid Larson4, Vincent S Staggs5,2

  • 1Division of Hospital Medicine, Department of Pediatrics.

Hospital Pediatrics
|September 11, 2023
PubMed

Insights

Mechanical restraint use in hospitalized children is higher for those with prior restraint, certain mental health diagnoses, males, and Black children. These findings highlight potential racial inequities in pediatric restraint.

Area of Science:

  • Pediatric hospital medicine
  • Child and adolescent psychiatry
  • Health equity research

Background:

  • Mechanical restraint is linked to adverse mental health outcomes, injury risks, and disparities.
  • Understanding restraint use in hospitalized children is crucial due to rising complex mental health needs.

Purpose of the Study:

  • To identify demographic and clinical factors associated with mechanical restraint use in hospitalized children.

Main Methods:

  • Retrospective cohort study of pediatric hospitalizations from 2017-2021 at a single center.
  • Electronic health records were used to identify restraint encounters.
  • Logistic regression modeling analyzed odds of restraint based on patient and hospitalization characteristics.

Main Results:

  • Mechanical restraint was used in 275 encounters among 29,808 children.
  • Higher odds of restraint were associated with prior restraint use (aOR 8.6), psychotic disorders (aOR 5.4), disruptive disorders (aOR 4.7), male sex (aOR 1.9), and Black race (aOR 1.9) compared to White patients.
  • Confidence intervals indicate statistically significant associations for all listed factors.

Conclusions:

  • The study indicates racial inequities in mechanical restraint use among hospitalized children.
  • These inequities parallel those observed in emergency department and adult settings.
  • Addressing behavioral needs and promoting health equity are essential for reducing restraint use.
Abstract

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