Psychological and cognitive support after cardiac arrest: a systematic review.

BACKGROUND

Adult survivors of cardiac arrest (CA) with favourable neurological recovery often experience persistent cognitive and psychological difficulties that impact quality of life and functional independence. However, post-discharge interventions remain heterogeneous, and evidence to support the prioritisation and implementation of specific cognitive and psychological interventions is limited.

OBJECTIVE

To systematically review the evidence on psychological and cognitive support interventions delivered after hospital discharge in adult CA survivors with good neurological recovery.

METHODS

A systematic review was conducted following PRISMA 2020 guidelines (PROSPERO CRD420251267160). Eligible studies included adults surviving CA with favourable neurological recovery who received structured post-discharge interventions. Outcomes were assessed across multiple domains, including: psychological well-being; cognitive performance; functional status and participation; health-related and global quality of life; and feasibility and implementation.

RESULTS

Six studies (n = 352 survivors) were included: two randomised controlled trials, two feasibility/pre-post studies, one single-case experimental design, and one process evaluation. Interventions varied in content and delivery (face-to-face, remote, home-based) and included nurse-led follow-up, psychotherapy, cognitive rehabilitation, and mindfulness-based strategies. Small improvements were observed in anxiety, depression, post-traumatic stress symptoms, and selected health-related quality-of-life domains, whereas cognitive, functional, and participation in daily and social activities showed limited or short-term gains in small uncontrolled studies. Interventions were feasible and well-tolerated.

CONCLUSIONS

Post-discharge psychological and cognitive interventions are feasible and associated with modest improvements in psychological well-being and selected quality-of-life domains. Further rigorous research using standardised outcomes is needed.