Evidence map›Paper›PMID 29796750›Full record

ArticleGeneral thoracic and cardiovascular surgery2018

Does cognition improve following LVAD implantation?

Marykay A Pavol, Joshua Z Willey, Ying Wei, Melana Yuzefpolskaya, Randolph S Marshall, Philip J Marascalco, Jason Harwood, Ronald M Lazar

Abstract read
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In one paragraph

Article in General thoracic and cardiovascular surgery, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Marykay A PavolStroke Division, Department of Neurology, Columbia University College of Physicians and Surgeons, New York, NY, 10032, USA. mp2740@cumc.columbia.edu.ORCID http://orcid.org/0000-0002-0270-7443
Joshua Z WilleyStroke Division, Department of Neurology, Columbia University College of Physicians and Surgeons, New York, NY, 10032, USA.
Ying WeiDepartment of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, USA.
Melana YuzefpolskayaCardiology Division, Department of Medicine,, Columbia University College of Physicians and Surgeons, New York, NY, USA.
Randolph S MarshallStroke Division, Department of Neurology, Columbia University College of Physicians and Surgeons, New York, NY, 10032, USA.
Philip J MarascalcoTerumo Heart, Inc, Ann Arbor, MI, USA.
Jason HarwoodTerumo Heart, Inc, Ann Arbor, MI, USA.
Ronald M LazarStroke Division, Department of Neurology, Columbia University College of Physicians and Surgeons, New York, NY, 10032, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundStudies of cognition after LVAD surgery have produced mixed results. To explore whether cognition would improve, decline, or remain stable after LVAD surgery, we examined cognition before and 1- and 3-months after LVAD surgery. Patients with post-surgical stroke were excluded.

methods28 subjects (mean age = 54.31 ± 12 years) comprised an observational case series from the DuraHeart LVAS device® trial. Cognitive testing was performed at baseline, 1-month, and 3-month post-surgery, and included tests of attention, memory, language, visualmotor speed (TMT) and visualconstruction.

resultsNo difference in cognition was found between baseline and 1-month exams (means z score improvement = 0.06, p = 0.43) but cognition improved significantly between baseline and 3-month exams (mean z score improvement = 0.34, p < 0.00001). Examination of individual test scores found, after correction for multiple comparisons, only the TMT variable was significantly different at the 3-month exam.

conclusionsWe found significantly improved cognition 3 months after LVAD surgery in a subset of patients without post-surgical stroke. The reasons for the lack of cognitive improvement at the 1-month post-surgical assessment may include ongoing medical and physiological disruptions in the immediate post-operative period. Further research into the sources of delayed improvement is warranted. Cognitive assessments performed immediately after surgery should be interpreted with caution because the results may not reflect longer term cognitive outcomes. LVAD patients may require additional support to successfully manage their health in the weeks immediately following surgery but assistance needs may decrease over time.

Indexed as

Heart-Assist DevicesAdultAgedCognitionDisease ManagementFemaleHeart FailureHumansMaleMiddle AgedNeuropsychological TestsRetrospective StudiesTreatment OutcomeCognitionHeart-assist devicesHeart failureLVADNeuropsychology

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.