Abstract: Objective: To systematically evaluate the relationship between physical restraint and the risk of delirium in ICU patients. Methods: Search PubMed, EMbase, CENTRAL, Web of Science, CBM, CNKI, VIP and WanFang Data database for cohort studies on the relationship between physical restraint and the risk of delirium in ICU patients. The retrieval time was from the establishment of the database to December 31, 2020. Two researchers independently screened the literature and extracted data according to inclusion and exclusion criteria. The Newcastle-Ottawa Quality Scale (NOS) was used to evaluate the quality of the included studies, and the RevMan 5.3 software was used to conduct Meta-analysis of the data. Results: A total of 13 studies involving 5948 patients were included. Meta-analysis results showed that physical restraint could increase the risk of delirium in ICU patients [OR=6.47(3.40-12.31), P<0.001]. The results of subgroup Meta-analysis showed that the risk of delirium in physical restraint patients in comprehensive ICU or specialized ICU increased [OR=7.30(3.13-17.05), P<0.001; OR=5.67(1.84-17.51), P=0.003]; physical restraint of ICU patients in Asian or non-Asian regions increased the risk of delirium [OR=4.86(2.56-9.23), P<0.001; OR=14.96(2.34-95.62), P=0.004]. Conclusion: Current evidence suggested that physical restraint may increase the risk of delirium in ICU patients and more high-quality studies are needed to verify the above conclusions.

Key words: physical restraint; delirium; ICU patients; Meta-analysis