Global prevalence of postoperative hypoxemia among adult and pediatric surgical patients: a systematic review and meta-analysis

Abstract Background Postoperative hypoxemia refers to a condition where oxygen levels in the tissues or blood drop to insufficient levels following surgery. The aim of this review is to determine the global prevalence of postoperative hypoxemia among adult and pediatric surgical patients through a s...

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Main Authors: Yosef Belay Bizuneh, Mulualem Endeshaw Zeleke, Ashebir Mamay Gebru, Destaw Fetene Teshome, Fantahun Ayenew Mekonnen, Dessie Abebaw Angaw, Amare Belete Getahun
Format: Article
Language:English
Published: BMC 2025-06-01
Series:BMC Anesthesiology
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Online Access:https://doi.org/10.1186/s12871-025-03146-3
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author Yosef Belay Bizuneh
Mulualem Endeshaw Zeleke
Ashebir Mamay Gebru
Destaw Fetene Teshome
Fantahun Ayenew Mekonnen
Dessie Abebaw Angaw
Amare Belete Getahun
author_facet Yosef Belay Bizuneh
Mulualem Endeshaw Zeleke
Ashebir Mamay Gebru
Destaw Fetene Teshome
Fantahun Ayenew Mekonnen
Dessie Abebaw Angaw
Amare Belete Getahun
author_sort Yosef Belay Bizuneh
collection DOAJ
description Abstract Background Postoperative hypoxemia refers to a condition where oxygen levels in the tissues or blood drop to insufficient levels following surgery. The aim of this review is to determine the global prevalence of postoperative hypoxemia among adult and pediatric surgical patients through a systematic review and meta-analysis. Methods We performed a comprehensive search across multiple databases, including Pubmed, Embase and Scopus. Additionally, search engines such as Google Scholar and Google. The searching mechanism was using medical subject heading terms combining by Boolean operators. The process adhered to the PRISMA guidelines, ensuring a robust method for the review. The review was registered at PROSPERO with registration number CRD42024534623. Risk of bias or quality assessment was done using a standardized critical appraisal instrument. Publication bias was assessed using a funnel plot and Egger’s regression test. Pooled prevalence was estimated using random-effects. Subgroup analyses were conducted based on different factors. Additionally, to identify a single study effect sensitivity analysis was conducted. Result A total of 20 primary studies with 28,948 participants were included. The pooled prevalence of postoperative hypoxemia was 20.62% (95% CI: 17.02–24.22%). Publication bias was detected, with Egger’s regression test (p < 0.0001) indicating small-study effects. After imputing three studies, the pooled prevalence decreased from 20.62% (95% CI: 17.02–24.22%) to 16.76% (95% CI: 13.36–20.15%). Subgroup analysis showed the highest prevalence in Africa at 33.81% (95% CI: 25.51–42.1%) and in low-income countries at 33.81% (95% CI: 25.51–42.1%). Among emergency surgical patients, they had the higher prevalence, 21.38% (95% CI: 11.60-31.15%). Conclusion This meta-analysis showed a pooled prevalence of postoperative hypoxemia was 20.62%, which may be over reported due to publication bias. After data imputation, the revised prevalence was 16.76%. Higher rates are found in Africa and low-income countries, as well as emergency surgical patients.
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spelling doaj-art-bff0bbefbaaa4893af73512d7ecc1bbd2025-08-20T02:31:09ZengBMCBMC Anesthesiology1471-22532025-06-0125111010.1186/s12871-025-03146-3Global prevalence of postoperative hypoxemia among adult and pediatric surgical patients: a systematic review and meta-analysisYosef Belay Bizuneh0Mulualem Endeshaw Zeleke1Ashebir Mamay Gebru2Destaw Fetene Teshome3Fantahun Ayenew Mekonnen4Dessie Abebaw Angaw5Amare Belete Getahun6Department of Anesthesia, School of Medicine, College of Medicine and Health Sciences, University of GondarDepartment of Anesthesia, School of Medicine, College of Medicine and Health Sciences, University of GondarDepartment of Health Informatics, Teda College of Health SciencesDepartment of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of GondarDepartment of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of GondarDepartment of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of GondarDepartment of Anesthesia, School of Medicine, College of Medicine and Health Sciences, University of GondarAbstract Background Postoperative hypoxemia refers to a condition where oxygen levels in the tissues or blood drop to insufficient levels following surgery. The aim of this review is to determine the global prevalence of postoperative hypoxemia among adult and pediatric surgical patients through a systematic review and meta-analysis. Methods We performed a comprehensive search across multiple databases, including Pubmed, Embase and Scopus. Additionally, search engines such as Google Scholar and Google. The searching mechanism was using medical subject heading terms combining by Boolean operators. The process adhered to the PRISMA guidelines, ensuring a robust method for the review. The review was registered at PROSPERO with registration number CRD42024534623. Risk of bias or quality assessment was done using a standardized critical appraisal instrument. Publication bias was assessed using a funnel plot and Egger’s regression test. Pooled prevalence was estimated using random-effects. Subgroup analyses were conducted based on different factors. Additionally, to identify a single study effect sensitivity analysis was conducted. Result A total of 20 primary studies with 28,948 participants were included. The pooled prevalence of postoperative hypoxemia was 20.62% (95% CI: 17.02–24.22%). Publication bias was detected, with Egger’s regression test (p < 0.0001) indicating small-study effects. After imputing three studies, the pooled prevalence decreased from 20.62% (95% CI: 17.02–24.22%) to 16.76% (95% CI: 13.36–20.15%). Subgroup analysis showed the highest prevalence in Africa at 33.81% (95% CI: 25.51–42.1%) and in low-income countries at 33.81% (95% CI: 25.51–42.1%). Among emergency surgical patients, they had the higher prevalence, 21.38% (95% CI: 11.60-31.15%). Conclusion This meta-analysis showed a pooled prevalence of postoperative hypoxemia was 20.62%, which may be over reported due to publication bias. After data imputation, the revised prevalence was 16.76%. Higher rates are found in Africa and low-income countries, as well as emergency surgical patients.https://doi.org/10.1186/s12871-025-03146-3PostoperativeHypoxemiaSystematic reviewMeta-analysis
spellingShingle Yosef Belay Bizuneh
Mulualem Endeshaw Zeleke
Ashebir Mamay Gebru
Destaw Fetene Teshome
Fantahun Ayenew Mekonnen
Dessie Abebaw Angaw
Amare Belete Getahun
Global prevalence of postoperative hypoxemia among adult and pediatric surgical patients: a systematic review and meta-analysis
BMC Anesthesiology
Postoperative
Hypoxemia
Systematic review
Meta-analysis
title Global prevalence of postoperative hypoxemia among adult and pediatric surgical patients: a systematic review and meta-analysis
title_full Global prevalence of postoperative hypoxemia among adult and pediatric surgical patients: a systematic review and meta-analysis
title_fullStr Global prevalence of postoperative hypoxemia among adult and pediatric surgical patients: a systematic review and meta-analysis
title_full_unstemmed Global prevalence of postoperative hypoxemia among adult and pediatric surgical patients: a systematic review and meta-analysis
title_short Global prevalence of postoperative hypoxemia among adult and pediatric surgical patients: a systematic review and meta-analysis
title_sort global prevalence of postoperative hypoxemia among adult and pediatric surgical patients a systematic review and meta analysis
topic Postoperative
Hypoxemia
Systematic review
Meta-analysis
url https://doi.org/10.1186/s12871-025-03146-3
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