The prognostic implication of cognitive frailty assessment in patients undergoing left ventricular assist device (LVAD) implantation remains unclear. We conducted a systematic review to evaluate assessment strategies and their significance for patients undergoing LVAD implantation. A comprehensive search of PubMed, Embase, and the Cumulative Index to Nursing and Allied Health Literature from inception until September 2022 and a review of meeting proceedings were performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies that investigated the prognostic value of cognitive frailty or any related cognition-based assessment in patients undergoing LVAD implantation were included. Study characteristics, patient demographics, and type of cognitive assessment were extracted. Primary outcomes included length of stay, readmissions, and all-cause mortality. Of 664 records retrieved, 12 (4 prospective, 8 retrospective) involving 16 737 subjects (mean age, 56.9 years; 78.3% men) met inclusion criteria; 67% of studies used the Montreal Cognitive Assessment to assess cognitive frailty. Outcomes reported were highly variable, with 42% reporting readmission, 33% reporting LOS, and 83% reporting mortality data; only two studies provided data on all three. Cognitive frailty was associated with prolonged length of stay in 75% of studies reporting this outcome. Only 40% and 60% of studies that reported readmissions and mortality outcomes, respectively, suggested a predictive association. Pre-LVAD cognitive frailty is likely associated with worse outcomes postimplant. However, the heterogenous reporting of outcomes data and lack of consistent definitions in the literature limit its prognostic value. Additional research on markers for cognitive frailty and improved standards of reporting may allow for future analyses and enhance preoperative risk assessment and patient care. Geriatr Gerontol Int 2024; 24: 204–210.

中文翻译：

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患者选择和优化的新机遇：左心室辅助装置植入患者认知衰弱的系统评价

认知衰弱评估对接受左心室辅助装置（LVAD）植入的患者的预后意义尚不清楚。我们进行了系统评价，以评估评估策略及其对接受 LVAD 植入的患者的意义。根据系统评价和荟萃分析指南的首选报告项目，对 PubMed、Embase 以及护理和联合健康文献累积索引（从开始到 2022 年 9 月）进行了全面检索，并对会议记录进行了审查。纳入了调查接受 LVAD 植入的患者认知衰弱或任何相关的基于认知的评估的预后价值的研究。提取了研究特征、患者人口统计数据和认知评估类型。主要结局包括住院时间、再入院和全因死亡率。在检索到的 664 条记录中，有 12 条（4 条前瞻性，8 条回顾性）涉及 16 737 名受试者（平均年龄 56.9 岁；78.3% 男性）符合纳入标准； 67% 的研究使用蒙特利尔认知评估来评估认知脆弱性。报告的结果差异很大，42% 的人报告再入院，33% 的人报告 LOS，83% 的人报告死亡率数据；只有两项研究提供了所有三项的数据。在报告这一结果的研究中，75% 的研究表明认知衰弱与住院时间延长有关。在分别报告再入院和死亡率结果的研究中，只有 40% 和 60% 表明存在预测关联。 LVAD 前的认知脆弱可能与植入后较差的结果有关。然而，结果数据报告的异质性和文献中缺乏一致的定义限制了其预后价值。对认知衰弱标志物的进一步研究和改进的报告标准可能有助于未来的分析并加强术前风险评估和患者护理。老年老年国际 2024； 24：204-210。