In this study, 82% of unplanned extubations
occurred in patients with physical restraints. This finding
is similar to the results of other studies,1,3 which
indicate that use of physical restraint not only is inadequate
in preventing unplanned extubation but actually
promotes unplanned extubation. Because the GCS
scores and rates of nosocomial infection were higher in
physically restrained subjects (Table 2), it seems likely
that patients who had a higher level of consciousness
and also had a nosocomial infection had higher rates
of being physically restrained, and the 3 risk factors
tended to aggregate and led to unplanned extubation.
However, GCS scores did not differ significantly
between the unplanned extubation group and the control
group if the patients were physically restrained,