Pre-existing Conditions and Their Effect on Neurological Prognosis and Rehabilitation in Older Cardiac Arrest Population - A Literature Review

Pre-existing Conditions and Their Effect on Neurological Prognosis and Rehabilitation in Older Cardiac Arrest Population - A Literature Review

The effectiveness of cardiac arrest rehabilitation can be influenced by pre-existing conditions, such as diabetes and hypertension particularly in the older population, where these comorbidities are more prevalent. This literature review aims to understand how these conditions affect the neurological prognosis and rehabilitation in cardiac arrest patients aged 60+. A systematic PubMed search was conducted for peer-reviewed studies published within the past 15 years using terms related to cardiac arrest, neurological outcomes, rehabilitation, and common chronic conditions. Studies were included if they focused on adults aged 60 and older, reported at least one pre-existing medical condition, and provided neurological rehabilitation outcome data following cardiac arrest. After screening, 51 articles met the criteria for full-text review. Older populations tend to showcase a slower short-term recovery with reduced long-term gains, and a need for structured neurorehabilitation after cardiac arrest. Hypertension is found to be age-dependent and does not specifically worsen outcomes. Patients with type II diabetes display a trend of lower neurorehabilitation after cardiac arrest though evidence is mixed as studies link diabetes to worse neurological outcomes via impaired cerebral perfusion and microvascular damage, while others find no significant association. The effectiveness of CPR duration was also suggested to be associated with the neurological prognosis This review indicates that physicians should incorporate patients’ medical histories into rehabilitation planning and closely monitor key parameters such as blood glucose and blood pressure.