Theoretical-Causal Validation of Risk Factors for the Nursing Diagnosis of Decreased Cardiac Output: A Systematic Review of the Literature with Meta-Analysis.

PurposeThis systematic review aimed to identify risk factors related to decreased cardiac output in adults, thereby supporting the theoretical-causal validation of the nursing diagnosis Risk for Decreased Cardiac Output.MethodsA systematic review of etiology and risk was conducted in accordance with recognized guidelines, including meta-analysis of studies published between 1987 and 2024. Observational studies involving adult and older adult populations were selected from major electronic databases. Data extraction and quality appraisal were independently performed by multiple reviewers. Effect measures were synthesized using a random-effects model, with heterogeneity assessed across studies.FindingsSixty-three studies were included, the majority with cohort designs. Key risk factors identified for decreased cardiac output were lower body surface area and lower body weight, with advanced age and female sex recognized as significant risk population characteristics. Associated conditions contributing to elevated risk included a history of stroke, shock, emergency cardiac surgery, diabetes, renal and pulmonary diseases, lower ejection fraction, and heart failure. Methodological variability in cardiac output measurement and significant heterogeneity among studies were notable challenges.ConclusionsSeveral significant risk factors for decreased cardiac output were identified and classified, providing scientific support for the theoretical-causal validation process of this nursing diagnosis. Addressing study heterogeneity and standardizing measurement methods are recommended for future research.Implications for Nursing PracticeThe findings reinforce the clinical relevance of the nursing diagnosis Risk for Decreased Cardiac Output and highlight the need for tailored interventions by nursing professionals to prevent complications among at-risk cardiovascular patients.