Effervescent agents in acute esophageal food impaction

J. David, D. Backstedt, K. J. O’Keefe, K. Salehpour, R. D. Gerkin, Francisco C Ramirez

Research output: Contribution to journalArticle

Abstract

SUMMARY. Acute esophageal food impaction (AEFI) occurs frequently. Few data are published describing the use of effervescent agents (EAs) for treatment of AEFI. We aimed to evaluate the effectiveness, cost, and safety of EAs in the treatment of AEFI. We retrospectively identified patients aged 18 years and older who were seen in the emergency department of 2 hospitals in 1 metropolitan area from January 1, 2011, through April 4, 2016, who had a clinical diagnosis of AEFI. We collected and analyzed data on outcomes and cost associated with the use of EAs, glucagon, and no pharmacologic therapy. During the study period, 239 patients with AEFI met the inclusion criteria. Of the 45 patients who received EA monotherapy, 25 (55.6%) responded successfully, compared with 11 of 62 (17.7%) who received glucagon monotherapy (P < .001) and 16 of 93 (17.2%) who had no therapy (P < .001). Ten of 39 patients (25.6%) who were given both glucagon and EA responded successfully. The other 177 patients had endoscopy, which was successful in all cases. Median hospitalization charges for patients who responded successfully to EA alone were $1,136, compared with $2,602 for responders to glucagon alone (P < .001) and $1,194 for those who cleared their bolus spontaneously (P < .001). All patients who received EA monotherapy had lower median hospitalization costs ($2,384) than all patients who received glucagon monotherapy ($9,289; P = .03) and all patients who received neither ($8,386; P = .02). Effervescent agents are a safe, effective, and cost-saving initial strategy in the treatment of acute esophageal food impaction.

Original languageEnglish (US)
JournalDiseases of the Esophagus
Volume32
Issue number4
DOIs
StatePublished - Jan 1 2019

Fingerprint

Food
Glucagon
Costs and Cost Analysis
Hospitalization
Therapeutics
Endoscopy
Cost-Benefit Analysis
Hospital Emergency Service
Safety

Keywords

  • Dysphagia
  • Endoscopy
  • Esophagus
  • Foreign bodies
  • Swallowing disorders

ASJC Scopus subject areas

  • Gastroenterology

Cite this

David, J., Backstedt, D., O’Keefe, K. J., Salehpour, K., Gerkin, R. D., & Ramirez, F. C. (2019). Effervescent agents in acute esophageal food impaction. Diseases of the Esophagus, 32(4). https://doi.org/10.1093/dote/doy117

Effervescent agents in acute esophageal food impaction. / David, J.; Backstedt, D.; O’Keefe, K. J.; Salehpour, K.; Gerkin, R. D.; Ramirez, Francisco C.

In: Diseases of the Esophagus, Vol. 32, No. 4, 01.01.2019.

Research output: Contribution to journalArticle

David, J, Backstedt, D, O’Keefe, KJ, Salehpour, K, Gerkin, RD & Ramirez, FC 2019, 'Effervescent agents in acute esophageal food impaction', Diseases of the Esophagus, vol. 32, no. 4. https://doi.org/10.1093/dote/doy117
David, J. ; Backstedt, D. ; O’Keefe, K. J. ; Salehpour, K. ; Gerkin, R. D. ; Ramirez, Francisco C. / Effervescent agents in acute esophageal food impaction. In: Diseases of the Esophagus. 2019 ; Vol. 32, No. 4.
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