Disparities in Pharmacologic Restraint Use in Pediatric Emergency Departments

• DOI: 10.1542/peds.2022-056667
• Publication Date: 2022-12-19T08:06:37Z
• Authors: Ashley A. Foster; John J. Porter; Michael C. Monuteaux; Jennifer A. Hoffmann; Joyce Li; Lois K. Lee; Joel D. Hudgins
• Keywords: Male; Adult; Adolescent; Mental Disorders; Hospitals; 3. Good health; Young Adult; 03 medical and health sciences; 0302 clinical medicine; Odds Ratio; Humans; Child; Emergency Service, Hospital; Retrospective Studies

Emergency department (ED) utilization by children with mental and behavioral health (MBH) conditions is increasing. During these visits, pharmacologic restraint may be used to manage acute agitation. Factors associated use are not well described.This was a retrospective cohort study of ED visits from the Pediatric Health Information System database, 2010-2020. We included 3-21 years primary MBH diagnosis identified restraint. Regression models were analyze association between patient- hospital-level factors restraint.Of 545 800 over period, 22 194 (4.1%) involved use. In multivariable analysis, ages 18-21 (odds ratio [OR], 1.88; 95% confidence interval [CI], 1.59-2.22), male sex (OR, 1.25; CI, 1.16-1.34), Black race 1.22; 1.09-1.35), starting overnight 1.68; 1.45-1.96), or weekend 1.26; 1.22-1.30), repeat 1.31; 1.17-1.47). Every 100-visit increase in average annual volume 0.09% decrease (95% -0.15 -0.04) no significant -0.25 0.25).For conditions, years, sex, race, weekend, These results can inform strategies reduce ensure safe equitable care.