Related Experiment Video
Updated: Nov 5, 2025
Use of a Percutaneous Ventricular Assist Device/Left Atrium to Femoral Artery Bypass System for Cardiogenic Shock
Published on: August 16, 2021
Cognition predicts days-alive-out-of-hospital after LVAD implantation
Marykay A Pavol1, Amelia K Boehme2, Melana Yuzefpolskaya3
1Department of Neurology, Stroke Division, Columbia University Irving Medical Center, New York, NY, USA.
Insights
Pre-implantation cognitive function in heart failure patients predicts time spent out of the hospital after left ventricular assist device (LVAD) surgery. This finding highlights cognition as a key factor in post-LVAD recovery and hospitalization rates.
Area of Science:
- Cardiology
- Neuropsychology
- Medical Devices
Background:
- Heart failure (HF) management often involves advanced therapies like left ventricular assist device (LVAD) implantation.
- Cognitive function is known to impact health outcomes in various patient populations.
- The relationship between pre-operative cognition and post-LVAD hospitalization has not been previously investigated.
Purpose of the Study:
- To examine the association between cognitive performance and days-alive-out-of-hospital (DAOH) in patients undergoing LVAD implantation.
- To determine if pre-LVAD cognitive status can predict post-operative hospitalization rates.
Main Methods:
- Retrospective analysis of 59 HF patients with pre-LVAD cognitive assessments.
- Cognitive function evaluated using tests of attention, memory, language, and visual motor speed, averaged into a single score.
- DAOH calculated as a percentage of days alive from LVAD surgery to transplant or 900 days; linear regression used for prediction.
Main Results:
- A linear regression model demonstrated that cognition significantly predicted DAOH (p=0.007).
- The overall model, including LVAD type and cognition, was significant (p=0.003, R²=0.19).
- LVAD type (continuous vs. pulsatile flow) was not a significant predictor of DAOH (p=0.08).
Conclusions:
- Pre-operative cognitive performance is a significant predictor of post-LVAD hospitalization.
- Patients with better cognitive function tend to spend more time out of the hospital after LVAD implantation.
- Further research is needed to explore the impact of pre-LVAD cognition on patient outcomes and hospitalization.
Objective:
Cognition influences hospitalization rates for a variety of patient groups but this association has not been examined in heart failure (HF) patients undergoing left ventricular assist device (LVAD) implantation. We used cognition to predict days-alive-out-of-hospital (DAOH) in patients after LVAD surgery.
Methods:
We retrospectively identified 59 HF patients with cognitive assessment prior to LVAD. Cognitive tests of attention, memory, language, and visual motor speed were averaged into one score. DAOH was converted to a percentage based on total days from LVAD surgery to either heart transplant or 900 days post-LVAD. Variables significantly associated with DAOH in univariate analyses were included in a linear regression model to predict DAOH.
Results:
A linear regression model including LVAD type (continuous or pulsatile flow) and cognition significantly predicted DAOH (F(2,54) = 6.44, p = 0.003, R2 = .19). Inspection of each variable revealed that cognition was a significant predictor in the model (β = .11, SE = .04, p = 0.007) but LVAD type was not (p = 0.08).
Conclusions:
Cognitive performance assessed prior to LVAD implantation predicted how much time patients spent out of the hospital following surgery. Further studies are warranted to identify the impact of pre-LVAD cognition on post-LVAD hospitalization.
