{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T17:10:51Z","timestamp":1792084251518,"version":"4.4.0"},"reference-count":49,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,3,14]],"date-time":"2025-03-14T00:00:00Z","timestamp":1741910400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Artificial Organs"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Frailty, marked by increased vulnerability and reduced physiological reserve, is common in end\u2010stage heart failure patients. Continuous flow left ventricular assist devices (LVADs) have improved outcomes, but the impact of frailty on these outcomes is unclear. This systematic review and meta\u2010analysis investigate the effect of frailty on clinical outcomes in patients undergoing LVAD therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Following PRISMA guidelines, we searched PubMed, Cochrane, EMBASE, MEDLINE, and Google Scholar up to September 2023 for studies comparing frail and non\u2010frail patients undergoing LVAD implantation. Data on mortality, hospital length of stay, intubation duration, bleeding, infection, and readmission rates were extracted and analyzed using the Mantel\u2013Haenszel random\u2010effects model, with heterogeneity assessed by the I2 statistic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Fifteen studies involving 3458 patients were included. Frailty was significantly associated with higher long\u2010term mortality (OR: 2.12; 95% CI: 1.17\u20133.83;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01), but not with short\u2010term mortality (OR: 1.61; 95% CI: 0.71\u20133.65;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.26), hospital length of stay (MD: 1.93; 95% CI: \u22129.83 to 13.68;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.75), or intubation duration (MD: 34.28; 95% CI: \u22121.15\u201369.71;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.06). No significant differences were found in bleeding (OR: 1.76; 95% CI: 0.76\u20134.10;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.19), infection (OR: 0.44; 95% CI: 0.11\u20131.84;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.26), or readmission rates (OR: 1.07; 95% CI: 0.78\u20131.46;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.68).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Frail patients with LVADs have higher long\u2010term mortality but similar short\u2010term outcomes, hospital stays, intubation times, bleeding, infection, and readmission rates compared to non\u2010frail patients. These findings highlight the need for tailored strategies to improve outcomes in frail LVAD patients and suggest further research on frailty interventions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aor.14998","type":"journal-article","created":{"date-parts":[[2025,3,15]],"date-time":"2025-03-15T02:43:51Z","timestamp":1742006631000},"page":"1367-1379","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Impact of Frailty in Patients With Continuous\u2010Flow Left Ventricular Assist Device Therapy in End\u2010Stage Heart Failure: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1111","volume":"49","author":[{"given":"Christos","family":"Costa","sequence":"first","affiliation":[{"name":"Department of Surgery and Cancer Imperial College London  London 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