# Association Between Nursing Diagnoses and Mortality in Patients with Cardiac Disease: A Retrospective Cohort Study

## TL;DR

This study found that certain nursing diagnoses in cardiac patients are linked to higher or lower in-hospital mortality risks, offering potential for better risk assessment in intensive care.

## Contribution

The study identifies specific nursing diagnoses as independent predictors of mortality in cardiac patients, a novel approach for risk stratification in critical care.

## Key findings

- Diagnoses like fluid volume excess and impaired cardiac output were strongly linked to higher mortality risks.
- Anxiety and impaired psychological comfort were associated with lower mortality risks.
- Nursing diagnoses may serve as clinical markers for predicting outcomes in cardiac intensive care.

## Abstract

Background/Objectives: Cardiovascular diseases represent a considerable burden on healthcare systems. In coronary intensive care units (CICU), nursing staff play a key role in the care of critically ill patients. Nursing diagnoses (NDs) based on the NANDA-I (North American Nursing Diagnosis Association-International) taxonomy enable the identification of human responses to various clinical conditions. However, their association with adverse outcomes, such as in-hospital mortality, remains understudied. Therefore, we evaluated the association between NDs and in-hospital mortality in patients with cardiac disease. Methods: A retrospective cohort study was conducted in a tertiary care hospital. The paper clinical records of 195 patients admitted to the CICU for at least 48 h between January 2023 and March 2025 were reviewed. The association of interest was assessed using Poisson regression models adjusted for confounding variables. Results: Mortality was 24.1%. NDs focusing on cardiac and extracardiac responses, such as fluid volume excess (risk ratio [RR] = 2.67; 95% confidence interval [CI] = 1.23, 5.76), impaired cardiac output (RR = 1.84; 95% CI = 1.50, 2.25), risk of shock (RR = 3.12; 95% CI = 1.91, 5.11), risk for impaired cardiovascular function (RR = 2.01; 95% CI = 1.28, 3.17), and impaired gas exchange (RR = 2.67; 95% CI = 1.64, 4.34) were significant predictors of mortality. In contrast, diagnoses such as anxiety (RR = 0.46; 95% CI = 0.23, 0.91), impaired psychological comfort (RR = 0.31; 95% CI = 0.09, 0.95), and risk of unstable glycemia (RR = 0.46; 95% CI = 0.23, 0.91) were associated with a lower risk of death. Conclusions: NDs are independently associated with in-hospital mortality in critically ill patients with cardiac disease and may represent useful clinical markers for risk stratification in intensive care settings.