• Joseph Mergui, David Raveh, Jean-Louis Golmard, Arik Fuer, Cornelius Gropp, and Sol Jaworowski.
• Department of Consultation, Shaare Zedek Medical Center, Jerusalem, Israel.
• Isr Med Assoc J. 2008 Oct 1; 10 (10): 681685681-5.

BackgroundGeneral hospital staff are often required to care for physically ill patients who arouse concern regarding risk of harm to themselves or others. Some of these patients,will be placed under one-to-one "constant observation." This is the first Israeli study of general hospital patients with high risk behavior.ObjectivesTo examine a population of general hospital patients whose behavioral management required the use of constant observation. Demographic and clinical parameters including physical diagnoses were examined, and risk factors for constant observation were identified. The findings of this study were compared to those of previous studies.MethodsThis prospective observational study examined 714 inpatients referred for psychiatric consultation; 150 were found to require constant observation, and 156 who did not served as a control group.ResultsIn this study younger age, suicidal concerns and alcohol/substance abuse were identified as risk factors for ordering constant observation. Ischemic heart disease and chronic obstructive pulmonary disease were the only physical diagnoses found to be significantly correlated with a longer duration of observation, regardless of admission duration. Constant observation was less frequently used in the management of organic brain syndrome patients in this study compared to other studies.ConclusionsSome of our results (predictive factors for constant observation) confirmed the findings of overseas studies. Our finding that a diagnosis of organic brain syndrome was not a predictive factor for constant observation was unexpected and requires further investigation. The correlation between a diagnosis of ischemic heart disease or COPD and duration of observation has not been reported previously and warrants further studies.

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