Prognosis for Cardiac Arrest Survivors

The majority of cardiac arrest survivors have some degree of brain injury and impaired consciousness. Some remain in a persistent vegetative state. Determining the survivor's prognosis and making the decision to treat or to withdraw care is complicated and based on many variables (many of which have not been thoroughly studied).

Factors before cardiac arrest:

  • Age
  • Ethnicity
  • Poor health including diabetes, cancer, infection, kidney disease and stroke

Factors during cardiac arrest:

  • Time between collapse and start of CPR/defibrillation
  • Quality of CPR/defibrillation
  • Whether survivor had any neurological function during or immediately after CPR

Factors after cardiac arrest and resuscitation:

  • Neurological function: Generally, poor function equals poor prognosis but could be complicated by medical instability and treatments. Some patients suffer a stroke after a cardiac arrest.
  • Neurophysiologic function: tests include somatosensory evoked potentials (SSEP) and electroencephalogram (EEG).
  • Neuroimaging and monitoring: to determine structural brain injury — such as cranial CT, MRI, magnetic resonance spectroscopy, positron emission tomography (PET) — mostly to exclude hemorrhage or stroke.
  • Biochemistry: from blood or cerebrospinal fluid
  • Whether therapeutic hypothermia (intentionally lowering the patient's body temperature) was used.