Impact of holding home stimulant(s) on agitation in a child and adolescent inpatient psychiatric population.

The Mental Health Clinician Pub Date : 2021-03-31 eCollection Date: 2021-03-01 DOI:10.9740/mhc.2021.03.050
Anupha M Mathew, Sophie Robert, Clint Ross, Erin Weeda, Adrienne Pruitt
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Abstract

Introduction: This study aimed to compare the rates of agitation-related interventions associated with initial holding versus continuation of home stimulant(s) in a child and adolescent population at the time of admission to an inpatient psychiatric facility.

Methods: This retrospective chart review included patients less than 18 years of age who were admitted to an academic medical center between July 1, 2017, and July 1, 2018. Patients were divided into 2 groups: those continued on their home stimulant(s) and those who had them held. We compared both groups on agitation-related outcomes by examining the difference in the number of level I or II events or as-needed medication administrations. Mechanical restraints and closed-door seclusions were grouped as level I events, and level II events consisted of nonmechanical restraint.

Results: The analysis included 169 patients. In total, 126 (75%) patients were continued on their home stimulant, and 43 (25%) had them held. The occurrence of the composite endpoint of level I or II events or as-needed intramuscular medication administration was numerically higher in the group that had their home stimulant held (27.9% vs 23%; P = .52). Level I events were also numerically higher but not statistically significant in the group that had their home stimulant held (16.3% vs 11.9%; P = .46).

Discussion: The composite outcome of as-needed intramuscular medication administration and level I or II events was numerically higher in the group that had their home stimulant held. Use of a larger sample size and adjusted analyses may help elucidate covariates that impact agitation-related outcomes.

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家中持有兴奋剂对儿童和青少年精神病住院患者躁动的影响。
简介:本研究旨在比较一名儿童和青少年在精神病院住院时,与初始持有和继续使用家庭兴奋剂相关的躁动相关干预的比率。方法:本回顾性研究纳入2017年7月1日至2018年7月1日在某学术医疗中心入院的年龄小于18岁的患者。患者被分为两组:一组继续使用家用兴奋剂,另一组使用家用兴奋剂。我们通过检查I级或II级事件或按需给药次数的差异来比较两组的躁动相关结果。机械约束和闭门隔离被归为一级事件,二级事件包括非机械约束。结果:共纳入169例患者。总共有126例(75%)患者继续使用家用兴奋剂,43例(25%)患者继续使用家用兴奋剂。在持有家用兴奋剂的组中,I级或II级事件或按需肌内给药的复合终点的发生率在数字上更高(27.9% vs 23%;p = .52)。一级事件在持有家用兴奋剂的组中也有较高的数字,但没有统计学意义(16.3% vs 11.9%;p = .46)。讨论:按需肌内给药和I级或II级事件的综合结果在持有家用兴奋剂的组中数值更高。使用更大的样本量和调整后的分析可能有助于阐明影响躁动相关结果的协变量。
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