Predictive Value of IPI for PACU Hypoxemia in Elderly Patients After General Anesthesia: A Retrospective Study

<b>Aims/Background</b> Elderly patients are at increased risk of hypoxemia in the post-anesthesia care unit (PACU) after general anesthesia. The Integrated Pulmonary Index (IPI) may have predictive value in identifying these patients. This study aimed to investigate the predictive value of the IPI for PACU hypoxemia in elderly patients after general anesthesia. <b>Methods</b> A retrospective analysis was conducted on 276 patients who underwent general anesthesia surgeries at Zhongshan Hospital, Fudan University, between December 2021 and December 2024. Patients were divided into a PACU hypoxemia group (n = 96) and a non-PACU hypoxemia group (n = 180). Univariate and binary logistic regression analyses were used to determine influencing factors, and a receiver operating characteristic (ROC) curve analysis was conducted to evaluate the predictive value of IPI for PACU hypoxemia in elderly patients after general anesthesia. <b>Results</b> Binary logistic regression analysis revealed that IPI was an independent influencing factor of PACU hypoxemia in elderly patients (<i>p</i> < 0.05). ROC analysis showed that IPI had an area under the curve of 0.843 (95% confidence interval [CI]: 0.799-0.887, <i>p</i> = 0.002), with a standard error of 0.023, a Youden index of 0.58, sensitivity of 85.42%, specificity of 72.22%, and an optimal cut-off value of 7.5. The discharge rate of patients with IPI >7.5 was significantly higher than that of patients with IPI ≤7.5 (<i>p</i> < 0.05). <b>Conclusion</b> IPI demonstrates a certain predictive value of PACU hypoxemia in elderly patients after general anesthesia.