Respiratory failure & ventilation
Sex-Specific Nonlinear Association Between Preoperative Hemoglobin and Intraoperative Oxygen Desaturation in High-Altitude Surgical Patients: A Retrospective Observational Study
Authors' conclusion
In high-altitude surgical patients receiving mechanical ventilation during general anesthesia, we identified sex-specific hemoglobin thresholds associated with intraoperative oxygen desaturation.
Study context
- Population
- High-altitude residents undergoing GA with mechanical ventilation for noncardiothoracic surgery, People's Hospital of Xizang Autonomous Region, January 2020–October 2024
- Participants
- 8,010 residents
- Exposure
- Preoperative hemoglobin concentration, by sex
- Malen = 3,622
- Femalen = 4,388
- Outcome
- Intraoperative oxygen desaturation (SpO2 <90% lasting ≥1 minute, pulse oximetry)
Methodological detailssingle-centre, sex-stratified, restricted cubic splines, piecewise logistic regression
- Single-centre
- Sex-stratified
- Restricted cubic splines
- Piecewise logistic regression
Main finding
As reported in the abstract
Intraoperative oxygen desaturation per 1 g/dL hemoglobin increase above threshold, by sex
Adjusted odds ratio per 1 g/dL increase (95% CI)P value
Malestatistical inflection point at 20.6 g/dL
1.50(1.18–1.92)
P = 0.001Femalethreshold 14.9 g/dL
1.33(1.13–1.58)
P < 0.001Maleclinically significant risk increase from 18.0 g/dL
1.23(1.05–1.45)
P = 0.012Per 1 g/dL hemoglobin increase above threshold, as printed
Observational data: associations, not effects.
Further findings
Sensitivity analyses (desaturation definitions, imputation methods)
- Findings validated across different definitions of desaturation and imputation methods
Original publication
Sex-Specific Nonlinear Association Between Preoperative Hemoglobin and Intraoperative Oxygen Desaturation in High-Altitude Surgical Patients: A Retrospective Observational Study. Anesth Analg. Published 15 July 2026. doi:10.
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