Gastric regurgitation predicts neurological outcome in out-of-hospital cardiac arrest survivors

•Gastric regurgitation during the first day of hospital admission is an early, easily available and independent predictor for poor neurological outcome in comatose out-of-hospital cardiac arrest survivors.•Association between gastric regurgitation and poor neurological outcome is more pronounced in multivariable models containing the clinical confounders first rhythm non-shockable, private location of collapse and cardiac arrest unwitnessed.•Measurement of gastric regurgitation is simple, inexpensive and routinely performed in critical care units. Hypoxic-ischemic brain injury can affect and disturb the autonomous nervous system (ANS), which regulates various visceral systems including the gastro-intestinal and emetic system. The present study aimed to analyze the predictive value of gastric regurgitation (GReg) for neurological outcome in out-of-hospital cardiac arrest (OHCA) survivors. In this prospective, single-center study, 79 OHCA survivors treated at a university-affiliated tertiary care centre were included and GReg was measured at the first day after successful cardiopulmonary resuscitation. Neurological outcome was assessed by the Cerebral Performance Categories score at discharge. Seventy-six percent of the study population had a poor neurological outcome. GReg was found to be associated with poor neurological outcome with an adjusted OR of 5.37 (95% CI 1.41–20.46; p = 0.01). The area under the ROC curve for GReg was 0.69 (95% CI, 0.56–0.81) for poor neurological outcome. GReg on the first day after OHCA is an early, strong and independent predictor for poor neurological outcome in comatose OHCA survivors. These results are particularly compelling because measurement of GReg is inexpensive and routinely performed in critical care units.