Out-of-hospital cardiac arrest (OHCA) is a major public health concern across the world. Statistics demonstrate that an average of 330,000 people in the United States and 275,000 people in Europe experience OHCAs every year (Kashiura et al., 2017). Moreover, the same statistics demonstrate that the survival rates for OHCAs are low. Cardiac arrests occur when the heart has stopped pumping blood to the body, accounting for many deaths across the world; most cardiac arrests happen outside hospital facilities (Hayashi et al., 2020). According to Paratz et al. (2020), cardiac arrests account for 20% of all Western deaths. Cardiac arrest is the result of a number of factors, and several scholars have attempted to determine the relationship between various prehospital factors such as the first recorded rhythm, age, and the survival rate after cardiac arrests. OHCAs affect society negatively and in a significant way (Shida et al., 2019). For instance, patients’ family members experience emotional burdens and the medical staff suffers vital implications. To rescue a cardiac arrest patient, medical professionals perform CPR, which includes rescue breathing such as mouth-to-mouth resuscitation and chest compressions (Zhan et al., 2017).
Patients experiencing cardiac arrest might have negative neurological outcomes. The outcomes of cardiac arrest are mainly related to its effects on the neurological system. The neurological outcome can be good or poor, depending on a variety of factors. Therefore, it is important to perform this assessment in situations where CPR procedures have been administered. The cerebral performance category (CPC) scale is tool for evaluation of neurological damage after cardiac arrest and describes patients mental ability from CPC = 1 to CPC = 5.
A study by Akin et al. (2021) conducted on 25 patients indicated that 41% had good neurological outcomes with a Cerebral Performance Category score of less than or equal to 2. The good outcomes were related to high-quality care and recognition of the cardiac arrest within the shortest time possible.
Park et al. (2018) found that of 65 cardiac arrest patients investigated, only 24.6% had positive neurological outcomes, whereas 75.4% had poor outcomes. Most poor prognoses are related to the withdrawal of life-sustaining therapy after the cardiac arrest. Therefore, it is important to carry out a neurological examination after cardiac arrest, including an examination of the different reflexes and motor responses. This examination can prompt interventions that are important to prevent further complications to the patient.
Duration plays a significant and crucial role in the identification of neurological outcomes after cardiac arrest. Health care workers should record good or poor neurological outcomes after a patient’s cardiac arrest. A study by Yukawa et al. (2017) indicated that patients had a good neurological outcome when the CPR duration was between 40 min. It also is important to initiate CPR within 40 min of the onset of cardiac arrest, either prehospital or in the hospital. With a shorter duration of CPR, the outcomes are positive.
Neurological outcomes manifest differently among different age groups. Ichord et al. (2018) found that pediatric patients who had experienced cardiac arrest showed mild impairments in their neurological outcomes. Therefore, the neurological results can be positive in pediatric patients. Hirlekar et al. (2017) found that neurological outcomes among the elderly progress with age. They examined people aged 70 years and over who had suffered a cardiac arrest. The results indicated that of those aged 70–79 years, 80–89 years, and 90 years, 92%, 93%, and 88%, respectively, had good neurological outcomes. These results proved that the elderly can have good neurological outcomes.
Males and females experience different manifestations of cardiac arrest. Lei et al. (2020) carried out a study to determine gender differences in neurological outcomes and found that females are more likely to have favorable neurological outcomes than males. After an admission, the females received fewer interventions such as coronary artery angiography and percutaneous coronary intervention, which are important for cardiac arrest patients.
In cases of trauma, the outcomes can be a bit different. Brain injury is one of the traumas that can cause cardiac arrest. According to Zhao et al. (2021), among 42 patients who had a traumatic cardiac arrest, eight survived until the time of discharge, and only seven survived with good neurological outcomes. Therefore, it is important to resuscitate those with traumatic injuries because some have good outcomes.
Poor outcomes result from a lack of proper intervention and early detection of cardiac arrest. Death results from too much trauma or the presence of medical conditions that complicate intervention (Oh et al., 2017). Pediatric patients can be linked to poor outcomes because of their ongoing neurodevelopment, which cardiac arrest can greatly affect. It causes most of their Cerebral Performance Category scores to be 3–4.
The above mentioned literature provides evidence of the importance of understanding the overall effects of CPR duration on neurological outcomes. Health care professionals have made attempts to terminate CPR’s use to stop the effects that can arise from its administration. Nonetheless, various organizations have argued that the procedure should not be discontinued entirely; instead, health care professionals should be granted the right to weigh the benefits of its administration as part of the CPR protocol (Kashiura et al., 2017). No study has been conducted in Industrial Jubail, Saudi Arabia, to determine the impact of CPR duration on neurological outcomes of OHCA and the influencing factors. This study sought to explore the relationship between CPR duration and the achievement of neurologically favorable outcomes at a secondary hospital in Industrial Jubail.