Predictors of recurrent esophageal food impaction: a case-control study.
BACKGROUND
Esophageal food impaction (FI) is a distressing condition requiring urgent endoscopic intervention, with a reported recurrence rate between 10% and 20%. Knowledge of factors predisposing to recurrent FI may enable preventive measures to minimize the risk of recurrence.


OBJECTIVE
To identify risk factors associated with recurrent FI.


METHODS
Retrospective case-control study.


METHODS
Tertiary referral center.


METHODS
A prospectively maintained database and medical records of all patients undergoing emergent endoscopy for FI from 1989 to 2000 were reviewed. Cases were defined as those presenting with more than 1 episode of FI, whereas controls were defined as those without recurrence within 5 years of the index episode. Several demographic, clinical, endoscopic, and follow-up variables were extracted. Statistical analysis included chi2 tests and t tests for univariate analysis, and stepwise logistic regression for multivariate analysis.


METHODS
NA.


METHODS
Predictors of recurrent FI.


RESULTS
A total of 52 cases and 124 controls were identified (recurrence rate 30%). Presence of a diaphragmatic hernia [odds ratio (OR) 2.65; confidence interval (CI) 1.19-5.89], disimpaction by piecemeal extraction (OR 2.32; CI 1.09-4.97), and acquisition of esophageal biopsies (OR 3.69; CI 1.42-9.66) increased odds for recurrent FI. Physician follow-up after FI decreased the odds for recurrent FI (OR 0.38; CI 0.18-0.80).


CONCLUSIONS
Retrospective study.


CONCLUSIONS
The presence of a diaphragmatic hernia, complexity of endoscopic disimpaction technique, and lack of follow-up increased risk for recurrent FI. Collection of esophageal biopsies as a risk factor suggests a visibly more severe esophageal disorder as a potential cause for recurrent FI.
Prasad
Ganapathy A
GA
Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, MN 55905, USA. prasad.ganapathy@mayo.edu
Reddy
Jagadeshwar G
JG
Boyd-Enders
Felicity T
FT
Schmoll
Jeffrey A
JA
Lewis
Jason T
JT
Wongkeesong
Louis-Michel
LM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D004940:Esophageal Stenosis / Q000150:complications; D004941:Esophagitis / Q000150:complications; D004945:Esophagoscopy / Q000009:adverse effects; D004947:Esophagus; D005260:Female; D005502:Food; D005547:Foreign Bodies; D006551:Hernia, Hiatal / Q000150:complications; D006801:Humans; D008297:Male; D008460:Meat; D008875:Middle Aged; D012008:Recurrence; D012307:Risk Factors