Background:This study aimed to determine whether preoperative cognitive screening using the Mini-Cognitive Assessment Instru-ment(Mini-Cog)was useful for predicting the need for postoperative rehabilitation interventi...Background:This study aimed to determine whether preoperative cognitive screening using the Mini-Cognitive Assessment Instru-ment(Mini-Cog)was useful for predicting the need for postoperative rehabilitation intervention in patients with bladder cancer who un-derwent radical cystectomy.Materials and methods:We collected the medical records of consecutive patients who underwent radical cystectomy and preoperative cognitive screening based on the Mini-Cog test in our department between 2020 and 2021(n=114).Univariate and multivariate logistic re-gression analyses were used to identify the clinical risk factors for requiring rehabilitation intervention because of failure to wean postoperatively.Results:The median age of the participants was 76 years,and 96(84%)were male.Of the 114 patients,31(27%)required rehabilita-tion intervention for weaning.Based on the Mini-Cog test,the patients were classified into 2 groups:22(19%)had probable cognitive impairment(Mini-Cog score<3).Of the 22 patients with a Mini-Cog score of<3,13(59%)required rehabilitation intervention because of failure to wean postoperatively.In the multivariate analysis,being 75 years or older(odds ratio[OR],9.7;95%confidence interval[CI],2.6–36.3;p<0.001),a Mini-Cog score of<3(OR,3.7;95%CI,1.2–11.2;p=0.02),and an operative time≥310 minutes(OR,3.6;95%CI,1.1–11.9;p=0.04)were independent risk factors for requiring postoperative rehabilitation intervention.Conclusions:Effective screening with the Mini-Cog test,a simple cognitive screening tool with only 2 components(delayed 3-word recall task and clock drawing),reflects not only cognitive function but also physical frailty and may lead to the establishment of appro-priate rehabilitation programs during the perioperative period for early patient mobility after surgery.展开更多
Background:This study aimed to evaluate the impact of the clock drawing test(CDT)on postoperative delirium and compare the abilities of the mini-cognitive(Mini-Cog)test and the CDT for predicting postoperative deliriu...Background:This study aimed to evaluate the impact of the clock drawing test(CDT)on postoperative delirium and compare the abilities of the mini-cognitive(Mini-Cog)test and the CDT for predicting postoperative delirium after major urological cancer surgery.Materials and methods:In this single-center retrospective observational study,we collected the medical records of patients who underwent major urologic cancer surgery and preoperative cognitive screening based on the Mini-Cog test consisting of the CDT and the 3-word recall task at our department in 2020–2021(n=387).Univariate andmultivariate logistic regression analyses were used to identify the clinical risk factors for postoperative delirium.We also compared the ability of the CDT alone and the Mini-Cog test consisting of the CDT and 3-word recall task to predict postoperative delirium.Results:A total of 117 patients(30%)had abnormal CDT results.Postoperative delirium occurred in 29 patients(7%).On multivariate analysis,American Society of Anesthesiologists physical status≥3(odds ratio[OR],5.0;p=0.01),abnormal CDT(OR,4.8;p<0.001),preoperative benzodiazepine use(OR,4.9;p<0.001),and operative time≥237minutes(OR,3.0;p=0.01)were independent risk factors for postoperative delirium.The area under the curve for predicting postoperative deliriumwas 0.709 for CDT alone and 0.743 for the Mini-Cog test.No significant intergroup difference was observed(p=0.43).Conclusions:The CDT served as a formal but simple tool with adequate predictive power to identify the risk of postoperative delirium among patients undergoing major urological cancer surgery.Effective screening using the CDT might help provide optimal urological care for older patients.展开更多
文摘Background:This study aimed to determine whether preoperative cognitive screening using the Mini-Cognitive Assessment Instru-ment(Mini-Cog)was useful for predicting the need for postoperative rehabilitation intervention in patients with bladder cancer who un-derwent radical cystectomy.Materials and methods:We collected the medical records of consecutive patients who underwent radical cystectomy and preoperative cognitive screening based on the Mini-Cog test in our department between 2020 and 2021(n=114).Univariate and multivariate logistic re-gression analyses were used to identify the clinical risk factors for requiring rehabilitation intervention because of failure to wean postoperatively.Results:The median age of the participants was 76 years,and 96(84%)were male.Of the 114 patients,31(27%)required rehabilita-tion intervention for weaning.Based on the Mini-Cog test,the patients were classified into 2 groups:22(19%)had probable cognitive impairment(Mini-Cog score<3).Of the 22 patients with a Mini-Cog score of<3,13(59%)required rehabilitation intervention because of failure to wean postoperatively.In the multivariate analysis,being 75 years or older(odds ratio[OR],9.7;95%confidence interval[CI],2.6–36.3;p<0.001),a Mini-Cog score of<3(OR,3.7;95%CI,1.2–11.2;p=0.02),and an operative time≥310 minutes(OR,3.6;95%CI,1.1–11.9;p=0.04)were independent risk factors for requiring postoperative rehabilitation intervention.Conclusions:Effective screening with the Mini-Cog test,a simple cognitive screening tool with only 2 components(delayed 3-word recall task and clock drawing),reflects not only cognitive function but also physical frailty and may lead to the establishment of appro-priate rehabilitation programs during the perioperative period for early patient mobility after surgery.
文摘Background:This study aimed to evaluate the impact of the clock drawing test(CDT)on postoperative delirium and compare the abilities of the mini-cognitive(Mini-Cog)test and the CDT for predicting postoperative delirium after major urological cancer surgery.Materials and methods:In this single-center retrospective observational study,we collected the medical records of patients who underwent major urologic cancer surgery and preoperative cognitive screening based on the Mini-Cog test consisting of the CDT and the 3-word recall task at our department in 2020–2021(n=387).Univariate andmultivariate logistic regression analyses were used to identify the clinical risk factors for postoperative delirium.We also compared the ability of the CDT alone and the Mini-Cog test consisting of the CDT and 3-word recall task to predict postoperative delirium.Results:A total of 117 patients(30%)had abnormal CDT results.Postoperative delirium occurred in 29 patients(7%).On multivariate analysis,American Society of Anesthesiologists physical status≥3(odds ratio[OR],5.0;p=0.01),abnormal CDT(OR,4.8;p<0.001),preoperative benzodiazepine use(OR,4.9;p<0.001),and operative time≥237minutes(OR,3.0;p=0.01)were independent risk factors for postoperative delirium.The area under the curve for predicting postoperative deliriumwas 0.709 for CDT alone and 0.743 for the Mini-Cog test.No significant intergroup difference was observed(p=0.43).Conclusions:The CDT served as a formal but simple tool with adequate predictive power to identify the risk of postoperative delirium among patients undergoing major urological cancer surgery.Effective screening using the CDT might help provide optimal urological care for older patients.
