Near-death experiences after cardiac arrest: a scoping review

Near-death experiences may occur in more than one-third of patients who survive cardiac arrest, according to a scoping review of 11 prospective studies from various countries. The incidence ranged from 6.3% to 39.3%, varying between in-hospital (6.3–39.3%) and out-of-hospital (18.9–21.2%) cardiac arrest. Reported content of these experiences often reflected the language of the questionnaires used rather than participants' own words. Three studies that conducted follow-up all suggested a positive life attitude change, but one found significantly higher 30-day all-cause mortality in patients with near-death experiences versus those without, in non-controlled analysis. Lasting effects may be confounded by clinical characteristics.

Study at a glance

Abstract

Background This scoping review aimed to characterise near-death experiences in the setting of cardiac arrest, a phenomenon that is poorly understood and may have clinical consequences. Method PubMed/MEDLINE was searched to 23 July 2023 for prospective studies describing near-death experiences in cardiac arrest. PRISMA-ScR guidelines were adhered to. Qualitative and quantitative data were synthesised. Meta-analysis was precluded due to data heterogeneity. Results 60 records were identified, of which 11 studies involving interviews were included from various countries. Sample size ranged from 28–344, and proportion of female patients (when reported) was 0–50%, with mean age (when reported) ranging 54–64 years. Comorbidities and reasons for cardiac arrest were heterogeneously reported. Incidence of near-death experiences in the included studies varied from 6.3% to 39.3%; with variation between in-hospital (6.3–39.3%) versus out-of-hospital (18.9–21.2%) cardiac arrest. Individual variables regarding patient characteristics demonstrated statistically significant association with propensity for near-death experiences. Reported content of near-death experiences tended to reflect the language of the questionnaires used, rather than the true language used by individual study participants. Three studies conducted follow-up, and all suggested a positive life attitude change, however one found significantly higher 30-day all-cause mortality in patients with near-death experiences versus those without, in non-controlled analysis. Conclusions From prospective studies that have investigated the phenomenon, near-death experiences may occur in as frequent as over one-third of patients with cardiac arrest. Lasting effects may follow these events, however these could also be confounded by clinical characteristics.