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Table 3 Factors independently associated with number of days of physical restraints

From: Predictors of physical restraint use in Canadian intensive care units

Data point

Univariable

Multivariable

 

IRRa(95% CI)

IRRa(95% CI)

Patient characteristics

  

Age

1.01 (0.99-1.04)

1.00 (0.98-1.03)

Male sex

0.87 (0.37-2.06)

0.73 (0.35-1.54)

Psychiatric conditionb

1.13 (0.35-3.67)

1.27 (0.42-3.84)

Cognitive impairment (dementia)

0.17 (0.01-2.86)

0.28 (0.02-3.40)

Prior psychotropic drug usec

0.60 (0.26-1.41)

0.45 (0.19-1.06)

Smoking or alcohol consumption, habitual drug use

1.68 (0.71-3.98)

1.55 (0.73-3.27)

Patient category

  

  Surgical

1

1

  Medical

1.48 (0.58-3.78)

1.74 (0.72-4.22)

  Other

0.58 (0.19-1.72)

0.61 (0.24-1.56)

APACHE II score

0.97 (0.92-1.02)

0.97 (0.92-1.02)

Treatment characteristics

  

Medication use per mechanical ventilation days

  

  Benzodiazepines (10 mg incrementsd)

1.11 (1.05-1.17)

1.07 (1.01-1.13)

  Propofol (10 mg increments)

1.00 (1.00-1.01)

0.99 (0.99-1.00)

  Opioids (10 mg incrementse)

1.05 (1.00-1.01)

1.00 (0.99-1.10)

Daily sedation interruption

9.64 (4.23-21.94)

3.44 (1.46-8.10)

Sedation administration

  

  Intermittent use only

1

1

  Continuous infusion only

3.35 (0.93-12.16)

0.87 (0.23-3.22)

  Both

23.47 (5.97-92.27)

3.50 (0.88-13.89)

Antipsychotic prescription

45.10 (18.56-109.62)

15.67 (6.62-37.12)

Sedation-Agitation Scale scores

  

  Agitation (SAS >4)f

13.19 (4.12-42.15)

1.99 (0.63-6.27)

  Over-sedation (SAS <3)f

11.04 (4.56-26.70)

2.62 (1.08-6.35)

Adverse eventg

20.45 (3.98-105.14)

8.27 (2.07-33.08)

Hospital and ICU h characteristics

  

University-affiliated hospital (vs. community)

1.51 (0.63-3.61)

0.46 (0.15-1.43)

Closed ICUh model (vs. open model)

4.06 (1.34-12.26)

0.86 (0.25-3.00)

Proportion of ventilator capable beds in the ICUh

  

  <25%

1

1

  25-50%

7.75 (0.87-69.27)

15.82 (1.65-151.84)

  51-75%

1.97 (0.23-16.68)

5.99 (0.66-54.01)

  76-90%

7.66 (0.92-63.51)

31.76 (3.02-334.41)

  >90%

1.90 (0.16-22.47)

10.31 (0.67-157.93)

Nurse to patient ratio ever <1:1

2.73 (1.08-6.89)

1.75 (0.75-4.13)

Province

  

  Ontario

1

1

  Newfoundland and Labrador

3.63 (0.35-38.16)

3.59 (0.34-37.48)

  Nova Scotia

0.19 (0.00-14.37)

1.87 (0.04-97.96)

  New Brunswick

0.53 (0.01-39.05)

0.83 (0.01-46.75)

  Prince Edward Island

0.89 (0.04-21.49)

7.47 (0.42-133.77)

  Quebec

2.74 (0.35-21.55)

2.19 (0.31-15.38)

  Manitoba

1.40 (0.06-33.51)

8.95 (0.38-212.36)

  Saskatchewan

0.44 (0.05-3.71)

1.56 (0.17-14.82)

  Alberta

1.49 (0.05-47.70)

0.85 (0.04-20.32)

  British Columbia

1.10 (0.16-7.64)

0.93 (0.15-5.61)

  1. aIRR, incidence rate ratio; bpsychiatric condition included documented depression, anxiety, bipolar disorder, schizophrenia; cpsychotropic drugs included: sedative, narcotics, methadone, antidepressants; ddose expressed in midazolam equivalents (1 mg midazolam = 0.5 mg lorazepam); edose expressed in morphine equivalents (10 mg morphine = 2 mg hydromorphone = 0.1 mg fentanyl); fSedation-Agitation Scale; gadverse events comprised deliberate or accidental device removal (endotracheal tube, intravenous lines, feeding tubes, urinary catheters) by patients or accidental removal by staff, and danger to self or others; hICU, intensive care unit. APACHE II, Acute Physiology and Chronic Health Evaluation II.
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Critical Care

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