Ali Ümit EŞBAH, Serkan TORUN
Konuralp Tıp Dergisi - 2026;18(3):281-288
Aim: Intraprocedural hypoxemia is a common respiratory adverse event during sedated gastrointestinal endoscopy. This study aimed to identify factors associated with hypoxemia and to develop a simple preprocedural risk score using routinely available clinical variables. Material and Methods: This retrospective single-center study included 150 adults who underwent sedated ERCP or EUS between January 2015 and December 2025. Hypoxemia was defined as SpO? <90% during the procedure. Clinical, procedural, and sedation-related variables were analyzed. Logistic regression was used to identify factors associated with hypoxemia, and a preprocedural risk score was developed from variables available before sedation. Results: Hypoxemia occurred in 32 patients (21.3%). In multivariable analysis, body mass index, ASA III-IV status, chronic pulmonary disease, lower baseline SpO?, and procedure duration were associated with hypoxemia. Procedure duration was excluded from the score because it was not preprocedural. The final score included body mass index >=30 kg/m², ASA III-IV status, chronic pulmonary disease, and baseline SpO? <=95% (range, 0-7 points). Hypoxemia rates increased across low-, intermediate-, and high-risk groups (4.8 %, 20.8%, and 51.4%, respectively; p<0.001). The score yielded an AUC of 0.80 (95% CI: 0.72-0.88; p<0.001). At a cut-off of >=4 points, sensitivity was 56.3%, specificity was 85.6%, positive predictive value was 51.4%, negative predictive value was 87.8%, and accuracy was 79.3%. Conclusions: A simple preprocedural score based on body mass index, ASA physical status, chronic pulmonary disease, and baseline SpO? stratified hypoxemia risk in sedated gastroenterological endoscopy. External validation is required before routine clinical use.
