Practice Patterns and Outcomes of Patients With Retained Gastric Food Content Encountered During Endoscopy

Area of Science:

• Gastroenterology
• Endoscopy
• Patient Safety

Background:

• Retained gastric food content during upper endoscopy can compromise diagnostic accuracy and elevate aspiration risks.
• Understanding endoscopist practices and patient outcomes is essential for optimizing endoscopic procedures.

Purpose of the Study:

• To evaluate endoscopist practice patterns when encountering retained gastric food content.
• To assess clinical outcomes in patients with retained gastric food content during endoscopy.

Main Methods:

• A retrospective review of consecutive patients with retained gastric food content during first-time endoscopy.
• Primary endpoints included complete examination (deep duodenal intubation) and 30-day postprocedural respiratory adverse events.

Main Results:

• Of 17,868 endoscopies, 629 (3.5%) had retained gastric food content. Complete examination rates varied significantly among endoscopists (70.3%-98.0%).
• Large food burden decreased completion likelihood (aOR 0.3), while biopsies increased it (aOR 2.5). 9.2% required repeat endoscopy.
• Respiratory adverse events occurred in 6.5%, primarily in hospitalized patients (aOR 37.8) and those with large food content (aOR 2.1).

Conclusions:

• While deep duodenal intubation is often achieved, examination completeness varies with food burden and endoscopist skill.
• Respiratory adverse events are concentrated in hospitalized patients and linked to significant food content, often leading to respiratory failure.