The Lazarus Phenomenon Among Older People-A Descriptive Analysis of Cases Spanning over 40 Years

The Lazarus phenomenon (LP), also called auto-resuscitation, may happen after the end of ineffective cardiopulmonary resuscitation (CPR), or after death is confirmed in a person who did not undergo CPR, and heart activity returns spontaneously. The aim of the study was to focus on older individuals (aged >60) experiencing the LP and to analyse distractors that cause this phenomenon. Methods. PubMed, Scopus, and Web of Science electronic databases were searched to find cases of LP from the year 1982 until 31 December 2025. Of the 81 total cases found, 48 patients were included in the study. For the analysis they were divided into two subgroups dependent on age: No 1 (60-79), No 2 (≥80). Results. Based on the descriptive analysis, the causes of cardiac arrest were divided almost equally between cardiac and non-cardiac causes (47.6% and 52.3% respectively). Cardiac arrest occurred equally in the IH and OH. In 16 out of 37 cases where such data were reported, a return to consciousness was confirmed, representing 43.2%. Conclusions. In older people, even those of very advanced age, the Lazarus phenomenon may occur. Based on the analysis carried out and given the lack of available data and the small sample size (48 individuals), it is not possible at this stage to definitively identify the causes of LP in the elderly population. As a potential cause of LP, age-related changes should be taken into account. Given that LP also occurs in the older population, consideration should be given to the need for extended monitoring of vital signs following the declaration of death. With a view to raising awareness of LP, it seems appropriate to include information on this phenomenon in the CPR guidelines.