Hernández-Mariano José Ángel, Mendoza-Macario Olivia, Velázquez-Núñez María Del Carmen, Cedillo-Ordaz María Del Carmen, Cervantes-Guzmán Blanca Estela, Razo-Blanco-Hernández Dulce Milagros, Landeros-Olvera Erick Alberto, Villa-Rivas Fani, Castillo-Díaz Rocío, Cano-Verdugo Guillermo
Department of Research, Hospital Juarez of Mexico, Mexico City 07760, Mexico.
Department of Quality and Health Education, Ministry of Health, Mexico City 11400, Mexico.
Nurs Rep. 2025 Apr 28;15(5):147. doi: 10.3390/nursrep15050147.
Previous studies suggest that nursing diagnoses (NDs) could predict clinical outcomes, such as mortality, among patients with non-communicable diseases. However, evidence in patients with COVID-19 is still scarce. To evaluate the association between NDs and COVID-19 mortality among hospitalized patients. A retrospective cohort study was conducted on 498 paper clinical records of patients hospitalized for at least 72 h in the internal medicine unit for COVID-19 from June to December 2020. The interest association was assessed using logistic regression models. NDs focused on COVID-19 pulmonary responses, such as impaired gas exchange (OR = 3.04; 95% CI = 1.87, 4.95), impaired spontaneous ventilation (OR = 3.67; 95% CI = 2.17, 6.21), or ineffective airway clearance (OR = 2.47; 95% CI = 1.48, 4.12), were significant predictors of mortality. NDs on COVID-19 extrapulmonary responses, such as risk for unstable blood glucose level (OR = 2.45; 95% CI = 1.45, 4,15), risk for impaired liver function (OR = 2.02; 95% CI = 1.11, 3.63), hyperthermia (OR = 2.08; 95% CI = 1.29, 3.35), decreased cardiac output (OR = 2.95; 95% CI = 1.42, 6.11), or risk for shock (OR = 3.03; 95% CI = 1.28, 7.13), were associated with a higher risk of in-hospital mortality. Conversely, patients with NDs of fear (OR = 0.56; 95% CI = 0.35, 0.89) and anxiety (OR = 0.44; 95% CI = 0.26, 0.77) had a lower risk of death. NDs on pulmonary and extrapulmonary responses to COVID-19 were associated with in-hospital mortality, suggesting that they are indicators of the severity of these patients. Therefore, NDs may help nursing staff identify individuals who require closer monitoring and guide early interventions for their recovery.
先前的研究表明，护理诊断（NDs）可以预测非传染性疾病患者的临床结局，如死亡率。然而，关于新型冠状病毒肺炎（COVID-19）患者的证据仍然很少。为了评估住院患者中NDs与COVID-19死亡率之间的关联。对2020年6月至12月在内科病房因COVID-19住院至少72小时的498份纸质临床记录进行了一项回顾性队列研究。使用逻辑回归模型评估感兴趣的关联。关注COVID-19肺部反应的NDs，如气体交换受损（比值比[OR]=3.04；95%置信区间[CI]=1.87，4.95）、自主呼吸受损（OR=3.67；95%CI=2.17，6.21）或气道清除无效（OR=2.47；95%CI=1.48，4.12），是死亡率的显著预测因素。关于COVID-19肺外反应的NDs，如血糖水平不稳定风险（OR=2.45；95%CI=1.45，4.15）、肝功能受损风险（OR=2.02；95%CI=1.11，3.63）、体温过高（OR=2.08；95%CI=1.29，3.35）、心输出量减少（OR=2.95；95%CI=1.42，6.11）或休克风险（OR=3.03；95%CI=1.28，7.13），与住院死亡率较高相关。相反，有恐惧（OR=0.56；95%CI=0.35，0.89）和焦虑（OR=0.44；95%CI=0.26，0.77）NDs的患者死亡风险较低。对COVID-19的肺部和肺外反应的NDs与住院死亡率相关，表明它们是这些患者病情严重程度的指标。因此，NDs可能有助于护理人员识别需要密切监测的个体，并指导他们早期干预以促进康复。
