A comprehensive search was conducted across multiple databases, including PubMed, Google Scholar, Springer Link, Wiley, Cochrane Library, and ScienceDirect from January 2005 up to May 2023. Studies reporting on neurological outcomes, including cognitive function, quality of life, and mortality, in adult patients who experienced cardiopulmonary arrest were included following quality assessment.

A total of 12 studies meeting the inclusion criteria were identified and included in this systematic review. These studies encompassed a wide range of methodologies, including cohort studies, observational study, and clinical trials. A significant proportion of cardiac arrest patients achieve favourable neurological outcomes upon hospital discharge, despite limited predictive value from markers like optic nerve sheath diameter and pupil size. Early post-arrest inflammation, signaled by specific cytokines like IL-8 and IL-6, influences neurological prognosis. Comparing shockable and non-shockable cardiac arrest cases reveals the effectiveness of post-ROSC cooling, especially with shorter collapse-to-ROSC intervals. Combining clinical assessments with neuroprotein levels such as NSE and S-100 enhances predictive accuracy for poor neurological outcomes. Bradycardia during targeted temperature management is linked to lower mortality and better neurologic outcomes. Awareness of withdrawal of life-sustaining therapy timing and therapeutic strategies like moderate therapeutic hypothermia impact survival and neurological prognosis. Age and cardiac origin contribute to neurological outcome variations in out-of-hospital cardiac arrest patients. Neurological recovery, assessed using various tools such as the Glasgow Coma Scale and Cerebral Performance Category, was diverse, ranging from full neurological recovery to severe disability or death.

Innovative interventions and biomarkers offer promise, while the complexity of age, cardiac origin, and patient subsets adds nuance to prognosis. However, the absence of a standardised approach to assessing neurological outcomes hinders comparisons across studies.