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Predictors of adverse events and recurrence of esophageal food bolus impaction: a systematic review and meta-analysis #MMPMID41343721
Abu-Rumaileh M; Albandak M; Sawwaf B; Ghazaleh S; Abdelkarim M; Hallak Y; Alsayeh W; Abbarh S; Elhadi M; Khuder S; Nawras A; Alastal Y
Dis Esophagus 2025[Nov]; 38 (6): ? PMID41343721show ga
Esophageal food impaction (EFI) is a gastrointestinal emergency that often requires urgent endoscopy. Predictors of recurrence and adverse events remain understudied and inconsistently reported. We conducted a systematic review and meta-analysis to identify predictors of recurrence and adverse events in EFI. We systematically searched PubMed, Embase, and the Cochrane Library on March 1, 2025. We included any observational studies or clinical trials that evaluated EFI outcomes in adults. The primary outcomes were EFI recurrence and adverse events, assessed according to underlying esophageal pathology, biopsy practices, follow-up, and timing of endoscopy. Effect sizes were evaluated using odds ratios (ORs), and a random-effects model was applied. A total of 14 studies were included with 3116 patients. Male gender was modestly associated with a higher risk of EFI recurrence (OR 1.45; 95% CI 1.01-2.10; P = 0.05), and patients with eosinophilic esophagitis (EoE) had a markedly increased risk of recurrence (OR 3.28; 95% CI 2.09-5.14; P < 0.001). No significant associations with recurrence were observed for biopsy (OR 1.44; 95% CI 0.98-2.11; P = 0.06), those who underwent follow-up (OR 1.10; 95% CI 0.37-3.32; P = 0.74), gastroesophageal reflux disease (GERD) (OR 1.22; 95% CI 0.46-3.23; P = 0.68), or hiatal hernia (OR 1.84; 95% CI 0.51-6.65, P = 0.35). For any adverse events, neither a history of prior EFI (OR 1.80; 95% CI 0.26-12.26) nor the timing of endoscopy (OR 0.89; 95% CI 0.49-1.64) was significantly associated with increased risk. Similarly, gender, EoE, and GERD were not associated with increased risk of adverse events. Only the male gender and EoE were significantly associated with a higher risk of EFI recurrence. Other factors, including GERD, hiatal hernia, follow-up, and biopsy status, were not. Delayed endoscopy and prior EFI were not associated with increased adverse events. Large-scale studies are needed to define risk factors better and strengthen the risk-stratification guide for preventive strategies.
Dis+Esophagus 2025 ; 38 (6): ?
