Prognostic Value of Frailty for Heart Failure Patients Undergoing Left Ventricular Assist Device Implantation: A Systematic Review.

Autor:	Meece LE; From the Division of Cardiovascular Medicine, University of Florida, Gainesville, FL., Yu J; Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA., Winchester DE; From the Division of Cardiovascular Medicine, University of Florida, Gainesville, FL., Petersen M; Department of Medicine, University of Florida, Gainesville, FL., Jeng EI; Division of Thoracic and Cardiovascular Surgery, University of Florida, Gainesville, FL., Al-Ani MA; From the Division of Cardiovascular Medicine, University of Florida, Gainesville, FL., Parker AM; From the Division of Cardiovascular Medicine, University of Florida, Gainesville, FL., Vilaro JR; From the Division of Cardiovascular Medicine, University of Florida, Gainesville, FL., Aranda JM Jr; From the Division of Cardiovascular Medicine, University of Florida, Gainesville, FL., Ahmed MM; From the Division of Cardiovascular Medicine, University of Florida, Gainesville, FL.
Jazyk:	angličtina
Zdroj:	Cardiology in review [Cardiol Rev] 2024 Nov-Dec 01; Vol. 32 (6), pp. 483-488. Date of Electronic Publication: 2023 Mar 07.
DOI:	10.1097/CRD.0000000000000541
Abstrakt:	Frailty is associated with poor clinical outcomes in heart failure patients. The impact of frailty on outcomes following left ventricular assist device (LVAD) implantation, however, is less clearly defined. We therefore sought to conduct a systematic review to evaluate current frailty assessment strategies and their significance for patients undergoing LVAD implantation. We conducted a comprehensive electronic search of PubMed, Embase, and CINAHL databases from inception until April 2021 for studies examining frailty in patients undergoing LVAD implantation. Study characteristics, patient demographics, type of frailty measurement, and outcomes were extracted. Outcomes were organized into 5 basic categories: implant length of stay (iLOS), 1-year mortality, rehospitalization, adverse events, and quality of life (QOL). Of the 260 records retrieved, 23 studies involving 4935 patients satisfied the inclusion criteria. Approaches to measuring frailty varied, with the 2 most common being sarcopenia determined by computed tomography and Fried's frailty phenotype assessment. Outcomes of interest were also widely variable, with iLOS stay and mortality being the most frequently reported, albeit with differing definitions of both between studies. The heterogeneity among included studies precluded quantitative synthesis. Narrative synthesis showed that frailty by any measure is more likely to be associated with higher mortality, longer iLOS, more adverse events and worse QOL post-LVAD implant. Frailty can be a valuable prognostic indicator in patients undergoing LVAD implantation. Further studies are needed to determine the most sensitive frailty assessment, as well as the ways in which frailty may serve as a modifiable target to improve outcomes following LVAD implantation. Competing Interests: Disclosure: The authors have no conflicts of interest to report. (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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