ICU sedation, delirium & recovery
Previous-day physical restraint duration as a bedside signal for following-day delirium: a retrospective patient-day analysis in a mixed ICU
Authors' conclusion
In this single-center cohort, longer restraint duration on the previous day was associated with a higher risk of incident delirium the following day and may serve as a bedside-observable signal rather than evidence of a causal effect.
Study context
- Population
- ICU patient-days without previous-day delirium (Intensive Care Delirium Screening Checklist (ICDSC) 0–3), mixed ICU1,482 patient-days
- Participants
- 281 participants
- Exposure
- Previous-day physical restraint duration vs no restraint
- Outcome
- Incident delirium (ICDSC score ≥ 4)
- Follow-up
- Following day
Methodological detailssingle-centre, observational, patient-day unit of analysis, generalized linear mixed model with random intercept per patient, natural cubic spline (df = 3), 263 patient-days excluded due to coma
- Single-centre
- Observational
- Patient-day unit of analysis
- Generalized linear mixed model with random intercept per patient
- Natural cubic spline (df = 3)
- 263 patient-days excluded due to coma
Main finding
As reported in the abstract
Following-day incident delirium
Each group vs no restraintOdds ratio (95% CI)
8 h
2.43(1.64–3.61)
16 h
5.16(3.39–7.85)
24 h
10.01(6.31–15.88)
- Incident delirium events in primary analysis (729 patient-days, 247 patients)
- 115 (15.8%)
- Non-linear association (likelihood ratio test)
- P < 0.001
Observational data: associations, not effects.
Further findings
Sensitivity analyses (complete-case, LOCF, best/worst-case, adjustment for previous-day mental status)
- Consistent results
Original publication
Previous-day physical restraint duration as a bedside signal for following-day delirium: a retrospective patient-day analysis in a mixed ICU. J Intensive Care. Published 14 July 2026. doi:10.
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