A preliminary study of the Saint Louis university mental status examination (SLUMS) for the assessment of cognition in moderate to severe traumatic brain injury patients

Abstract

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.