Key result
Recent physical restraint linked to fatal pulmonary embolism in psychiatric inpatients.
Why the study?
Fatal pulmonary embolism can occur in psychiatric inpatients without typical risk factors, but detailed case descriptions are limited.
Case Series (n=4)
No
Physical restraint in psychiatric inpatients may be an under-recognized risk factor for fatal pulmonary embolism, even in the absence of traditional VTE risk factors.
Physical restraint may signal fatal PE risk in psychiatric inpatients lacking traditional factors; hypothesis-generating, needs prospective confirmation.
We report four cases of fatal pulmonary embolism confirmed by autopsy among inpatients in a Hong Kong psychiatric hospital from 2010 to 2014. None of the four patients had a medical or premorbid condition associated with vascular thromboembolism or causing prolonged immobilisation. Only two patients were taking long-term antipsychotic medication, but all were physically restrained shortly before the event.
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Lee et al. (2019) conducted a case series in Psychiatric inpatients with fatal pulmonary embolism (n=4). Physical restraint was evaluated on Fatal pulmonary embolism. All four psychiatric inpatients who died from autopsy-confirmed pulmonary embolism had been physically restrained shortly before the fatal event, suggesting a potential association.
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