S965 Assessing Variability in Predictors of Adequate Follow-Up After Esophageal Food Bolus Impaction: A Retrospective Study and Literature Review

Introduction: Despite guidelines recommending comprehensive post-esophageal food bolus impaction (EFBI) evaluation, follow-up adherence varies. It remains unclear whether predictors of follow-up are consistent across studies 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 6 months). We compared demographic, clinical, and endoscopic variables. Predictors of follow-up were identified using univariate and multivariate logistic regression. We also reviewed similar studies to identify differences in populations, study designs, and factors influencing follow-up variability across studies. Results: Among 137 patients, 60 (43.8%) lacked adequate follow-up. Most of our patients were White (89.1%) and men (59.9%), with a mean age of 48.6 ± 18.8 years. Sixty-two patients (45.3%) presented with their first food impaction. Of those with previous food impactions, only 18.7% (14/75) were established with a gastroenterology (GI) provider. A documented history of dysphagia was present in 73.7% (101/137), while 33.6% (46/137) had pre-existing esophageal disease. On multivariate analysis, predictors of follow-up included White race (odds ratio [OR] 22.53; P < 0.001), county of residence (OR 0.35; P = 0.035), follow-up endoscopy orders (OR 7.19; P = 0.003), and scheduled GI appointments (OR 14.4; P < 0.001). A review of 7 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. Conclusion: Ambulatory follow-up after EFBI remains suboptimal, with 44% of our cohort lacking adequate follow-up within 6 months. We identified both modifiable and demographic predictors, including race, county of residence, and discharge planning practices. Our inclusive design and literature review revealed variability in follow-up rates and predictors across studies, highlighting the need for institution-specific strategies that address healthcare inequities and unexpected barriers. We offer recommendations to guide future research and quality improvement efforts.