医疗病房中的机械约束：防护设备安全吗？
Mechanical restraints on the medical wards: are protective devices safe?
作者信息
Lofgren R P, MacPherson D S, Granieri R, Myllenbeck S, Sprafka J M
机构信息
University of Pittsburgh, PA.
出版信息
Am J Public Health. 1989 Jun;79(6):735-8. doi: 10.2105/ajph.79.6.735.
Abstract
We prospectively identified 102 mechanically restrained hospital patients and determined their hospital course. The cohort was elderly, cognitively impaired with multiple chronic diseases. The in-hospital mortality was 21 percent. Nosocomial infection developed in 12 percent and new pressure sores in 22 percent. Prolonged use of restraints (greater than 4 days) was the strongest independent predictor of nosocomial infection (relative risk 1.8, 95% CI = 1.2, 2.8) and new pressure sores (RR 1.4, 95% CI = 1.1, 1.8) as determined by multiple logistic regression analysis. Patients placed in mechanical restraints for longer than four days experience frequent morbid events and should be monitored carefully.
摘要
我们前瞻性地识别了102名在医院接受机械约束的患者，并确定了他们的住院病程。该队列患者为老年人，患有多种慢性病且存在认知障碍。住院死亡率为21%。医院感染发生率为12%，新发压疮发生率为22%。通过多因素逻辑回归分析确定，长时间使用约束（超过4天）是医院感染（相对风险1.8，95%可信区间=1.2，2.8）和新发压疮（相对风险1.4，95%可信区间=1.1，1.8）的最强独立预测因素。接受机械约束超过四天的患者经常发生不良事件，应予以密切监测。
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