Risk factors for hypoxemia during pediatric anesthesia: a logistic regression analysis

To identify risk factors for hypoxemia in anesthetized children, offering a basis for targeted clinical prevention to reduce its occurrence.

A retrospective analysis was conducted on the clinical data from 342 children who underwent anesthesia in the Department of Anesthesiology, Pu'er People's Hospital, from January 2024 to June 2025. Based on the occurrence of hypoxemia, the patients were divided into a hypoxemia group (n=19) and a non-hypoxemia group (n=323). General clinical data, preoperative blood routine, surgery-related conditions, inflammatory indices, and operating room environmental factors were compared between the two groups. Logistic regression analysis was used to identify independent risk factors for hypoxemia during pediatric anesthesia. Scatter plots were drawn to illustrate correlations between each independent risk factor and hypoxemia occurrence. Receiver Operating Characteristic (ROC) curves, calibration curves, and Decision Curve Analysis (DCA) were applied to evaluate the predictive performance.

Multivariate logistic regression identified C-reactive Protein (CRP; OR=1.011, 95% CI=1.004-1.018) and anesthesia duration (OR=1.029, 95% CI=1.017-1.042) as independent risk factors for hypoxemia during pediatric anesthesia. ROC analysis showed that CRP (AUC=0.799) and anesthesia duration (AUC=0.849) had good predictive performance for hypoxemia occurrence during pediatric anesthesia. The calibration and DCA demonstrated satisfactory model performance.

Elevated CRP levels and prolonged anesthesia duration are independent risk factors for hypoxemia in children undergoing anesthesia.