Abstract

Objectives

To compare the sensitivity and specificity of the Saint Louis University Mental Status (SLUMS) examination, the Montreal Cognitive Assessment (MoCA) and the Mini-Mental State Examination (MMSE) in adults with moderate to severe traumatic brain injury (TBI).

Methods

In this cross-sectional study, 98 patients with moderate to severe TBI and 30 matched controls were evaluated. All participants were assessed using the MMSE, the MoCA and the SLUMS examination.

Results

The SLUMS, MoCA and MMSE scores of the TBI group were significantly lower than those of the control group, indicating that the cognitive function of patients with TBI was significantly impaired. The receiver operating characteristic (ROC) curve analysis indicated that the areas under the curve for the SLUMS examination, the MoCA and the MMSE were all greater than 0.8. There were no significant differences among the instruments, indicating that all three were equally effective for diagnosing cognitive impairment in patients with moderate to severe TBI. According to the ROC curve analysis, the optimal cutoff values for the SLUMS examination, the MoCA and the MMSE were 24.5, 21.5 and 28.5, respectively. At that cutoff value, the sensitivity and specificity of the SLUMS examination were well balanced, with both exceeding 80%.

Conclusions

The SLUMS examination is better suited than the MMSE or the MoCA for assessing cognitive function in patients with moderate to severe TBI.

中文翻译：

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圣路易斯大学精神状态检查（SLUMS）评估中重度创伤性脑损伤患者认知能力的初步研究

摘要

目标

比较圣路易斯大学精神状态 (SLUMS) 检查、蒙特利尔认知评估 (MoCA) 和简易精神状态检查 (MMSE) 对中度至重度创伤性脑损伤 (TBI) 成人的敏感性和特异性。

方法

在这项横断面研究中，对 98 名中度至重度 TBI 患者和 30 名匹配的对照进行了评估。所有参与者都使用 MMSE、MoCA 和 SLUMS 检查进行评估。

结果

TBI组的SLUMS、MoCA和MMSE评分均显着低于对照组，表明TBI患者的认知功能明显受损。受试者工作特征（ROC）曲线分析表明，SLUMS检查、MoCA和MMSE的曲线下面积均大于0.8。这些仪器之间没有显着差异，表明这三种仪器对诊断中度至重度 TBI 患者的认知障碍同样有效。根据ROC曲线分析，SLUMS检查、MoCA和MMSE的最佳截止值分别为24.5、21.5和28.5。在该临界值下，SLUMS 检查的敏感性和特异性达到了很好的平衡，均超过 80%。

结论

SLUMS 检查比 MMSE 或 MoCA 更适合评估中度至重度 TBI 患者的认知功能。