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
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.
