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. 2025 Apr 11;25(1):174.
doi: 10.1186/s12871-025-03043-9.

Analysis of risk factors for hypoxemia in PACU for patients undergoing thoracoscopic lung cancer resection based on logistic regression model

Xi Luo  1 , Yanmei Ying  1 , Lu Yin  1 , Pan Chang  2   3
Affiliations

Analysis of risk factors for hypoxemia in PACU for patients undergoing thoracoscopic lung cancer resection based on logistic regression model

Xi Luo et al. BMC Anesthesiol. .

Abstract

Objective: This study aims to identify risk factors of hypoxemia in patients undergoin thoracoscopic lung surgery during their stay in the post-anesthesia care unit (PACU). Hypoxemia was defined as any instance of SpO₂ ≤90% lasting for more than one minute during the PACU stay.

Methods: We conducted a prospective research involving 398 patients who underwent elective thoracoscopic lung surgery in West China Hospital, Sichuan University, from April to July 2024. Patients were classified into hypoxemia and non-hypoxemia groups based on the presence of hypoxemia in the PACU. We compared clinical data between the two groups to identify factors influencing hypoxemia. Variables with statistical significance (P < 0.05) in univariate analysis were included in logistic regression to identify independent risk factors for hypoxemia.

Results: Among the 398 patients studied, 149 (37.4%) experienced hypoxemia. Univariate analysis indicated significant differences in age, BMI, height, ASA classification, hypertension, diabetes, lung function test with Forced Expiratory Volume at 1 s / Forced Vital Capacity (FEV1/FVC), and awakening time between the groups. Logistic regression revealed that age, BMI, ASA classification, hypertension, diabetes, and awakening time were independent risk factors for hypoxemia during anesthesia recovery, while preoperative SpO2 upon entering operating room (OR = 0.882, 95% CI: 0.783-0.993, P = 0.038) was identified as a protective factor.

Conclusion: Age, BMI, ASA classification, and preoperative conditions such as hypertension and diabetes are found to contribute to an increased incidence of hypoxemia in PACU following thoracoscopic lung surgery. Emphasizing preoperative lung function assessments and enhanced monitoring may also facilitate timely interventions, thereby improving post-anesthesia recovery and patient outcomes.

Keywords: Duration of PACU stay; Hypoxemia; Logistic regression; PACU; Post-extubation pain; Postoperative recovery; SpO₂; Thoracoscopic lung surgery.

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Conflict of interest statement

Declarations. Human ethics and consent to participate: Prior to the recruitment of participants, this study received approval from the Ethics Committee of West China Hospital, Sichuan University (2024 − 611), and was registered on the Chinese Clinical Trial Registry (ChiCTR2400083595). The study design strictly adhered to the declaration of Helsinki and the STROBE statement. All participants signed a written informed consent form before enrolment. Consent for publication: Not Applicable. Competing interests: The authors declare no competing interests.

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