Analysis of Risk Factors for Hypoxemia in PACU for Patients Undergoing Thoracoscopic Lung Cancer Resection Based on Logistic Regression Model

Abstract Objective This study aims to analyze the prevalence and influencing factors of hypoxemia in patients following thoracoscopic lung surgery in the post-anesthetic care unit (PACU). Methods We conducted a prospective analysis 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 Second / 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 FEV1/FVC was a protective factor. Conclusion Effective management of elderly patients and those with high BMI, ASA classification, and attention to preoperative hypertension and diabetes may help reduce hypoxemia incidence in the PACU following thoracoscopic lung surgery. Emphasizing preoperative lung function assessment and enhanced monitoring can facilitate timely interventions, improving post-anesthesia recovery and patient outcomes.