ArticleTranslational gastroenterology and hepatology2026
Assessing variability in predictors of adequate follow-up after esophageal food bolus impaction: a retrospective study and literature review.
Article in Translational gastroenterology and hepatology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Despite guidelines recommending comprehensive post-esophageal food bolus impaction (EFBI) evaluation, follow-up adherence varies. It's unclear whether predictors of follow-up are consistent or unique to individual populations. We assess post EFBI follow-up rates and predictors at our center and compare them to existing literature. Methods: We retrospectively studied adults (≥18 years) presenting with EFBI between June 2021 and October 2024. Patients without follow-up data or with non-food bolus impactions were excluded. Patients were categorized by follow-up adequacy (endoscopy or office visit within six months). We compared demographic, clinical, and endoscopic variables. Predictors of follow-up were identified using univariable and multivariable logistic regression. We also reviewed comparable studies to evaluate differences in patient populations, study designs, and factors influencing follow-up rates. Results: Among 137 patients, 60 (44%) lacked adequate follow-up. On multivariable analysis, predictors of follow-up included Caucasian race [odds ratio (OR) 24.4, P<0.001], county of residence (OR 0.31, P=0.02), history of anti-reflux surgery (OR 6.57, P=0.03), suspecting esophageal disease at index encounter (OR 3.09, P=0.02), ordering follow-up endoscopy (OR 5.26, P=0.01), and scheduling gastroenterology/gastrointestinal (GI) appointments (OR 10.7, P<0.001). A review of seven comparable studies involving 1,663 patients revealed variability in follow-up rates (16% to 55%), predictors of follow-up, and inconsistencies in inclusion criteria and follow-up definitions. Conclusions: Ambulatory follow-up after EFBI remains suboptimal, with 44% of our cohort lacking follow-up within six months. Race was the strongest predictor; however, given the wide confidence interval, this finding should be interpreted as exploratory rather than definitive. Other modifiable and demographic predictors include county of residence and discharge-planning practices. Our literature review revealed variability in follow-up rates and predictors across studies, highlighting the need for institution-specific strategies that address healthcare inequities and barriers.
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