Introduction: Recently, the mini-cognitive assessment instrument (Mini-Cog) which scored in 2 parts of 3-word recall task and a clock drawing test has been validated as a screening tool for cognitive impairment. We aimed to evaluate whether preoperative baseline cognitive function, as assessed by the Mini-Cog, was associated with the proficiency of stoma management in bladder cancer patients who underwent radical cystectomy (RC) and stoma creation.
Methods: We reviewed the medical records of 72 patients who underwent RC with stoma creation between January 2020 and September 2021. The Mini-Cog test is 5-point scale, and score of <3 was defined as probable cognitive impairment. The proficiency of stoma management was scored on eight indicators. Each items assigned point of 0-2, and the proficiency scale of the stoma management (PSSM) was obtained via the summation of them (range 0-16). The relationship between the Mini-Cog assessment and the PSSM score was evaluated. Besides, univariate and multivariate logistic regression analysis were used to assess variables associated with poor acquisition of skills for stoma management (PSSM of <10).
Results: Seventeen (24%) patients were suggested probable cognitive impairment (Mini-Cog scores < 3). The box and whisker plot showed mean PSSM scores were significantly higher in the group with Mini-Cog score of = 3 than their counterparts (11.7 and 4.1 points, respectively; P < 0.001). Multivariate analysis revealed that the Mini-Cog score of < 3 (odds ratio [OR] = 14.4; 95% confidence interval [CI] = 3.1-67.4; P < 0.001) and body mass index of < 23.4 (OR = 8.7; 95% CI = 1.9-39.7; P = 0.005) were independent predict factors for poor acquisition of skills for stoma management.
Conclusions: The Mini-Cog test is a useful tool that predicts preoperatively which patients will not be able to manage their stoma independently.
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