Mortality and Infectious Adverse Events in Neutropenic Patients Undergoing Gastrointestinal Endoscopic Procedures: A...

Area of Science:

• Gastroenterology
• Infectious Diseases
• Oncology

Background:

• Gastrointestinal endoscopy safety in neutropenic patients is not well-established.
• Guidelines suggest increased infectious adverse events post-endoscopy in neutropenia.
• Systematic review and meta-analysis needed to assess risks.

Purpose of the Study:

• To systematically review and meta-analyze the safety of gastrointestinal endoscopy in neutropenic patients.
• To evaluate infection-related mortality and infectious adverse events.
• To assess the impact of preprocedural antibiotics.

Main Methods:

• Systematic search of multiple databases (Cochrane, Embase, PubMed, etc.) through September 2025.
• Inclusion of six cohort studies (N=1241) with outcome data on infections, mortality, and fever.
• Random-effects meta-analyses performed for primary and secondary outcomes.

Main Results:

• Pooled infection-related mortality was 0.0% (95% CI 0.00%-0.03%).
• Pooled incidence of infectious adverse events was 7.3% (95% CI 0.00%-25.57%), including bacteremia (2.4%) and new fever (4.8%).
• Preprocedural antibiotics did not significantly reduce infectious adverse events or bacteremia.

Conclusions:

• Gastrointestinal endoscopy demonstrated 0% infection-related mortality in neutropenic patients.
• Infectious adverse events occurred in 7.3% of cases, suggesting a manageable risk profile.
• Endoscopy may be safely performed in appropriately selected neutropenic patients.