{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T18:22:52Z","timestamp":1785867772442,"version":"3.56.0"},"reference-count":32,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2024,12,20]],"date-time":"2024-12-20T00:00:00Z","timestamp":1734652800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"MH CZ\u2014DRO","award":["FNOs\/2025"],"award-info":[{"award-number":["FNOs\/2025"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Postoperative pneumonia and complications significantly impact outcomes in thoracic surgery, particularly for patients undergoing lobectomy for non-small cell lung cancer (NSCLC). This study evaluates whether preoperative premedication influences the risk of postoperative pneumonia and overall complications. Materials and Methods: This retrospective study included 346 patients who underwent lobectomy for NSCLC at the University Hospital Ostrava between 2015 and 2021. Data on demographic variables, tumour staging, surgical approach, and premedication (anticholinergics, benzodiazepines, antihistamines, and analgesics) were analysed. Postoperative outcomes included pneumonia and complications classified by the modified Clavien\u2013Dindo system. Results: Premedication was not significantly associated with postoperative pneumonia (10.7%) or overall complications (26.0%). Tumour size was the only factor significantly associated with complications, with larger tumours increasing the odds (OR: 1.16, p = 0.032). Other factors, including age, ASA classification, BMI, and surgical approach, did not demonstrate significant associations with postoperative outcomes. Conclusions: Premedication does not appear to significantly influence the risk of postoperative pneumonia or overall complications in patients undergoing lobectomy for NSCLC. Similarly, other clinical variables, such as age, ASA classification, BMI, and surgical approach, also did not show significant associations with these outcomes. These findings suggest that premedication can be individualised without increasing postoperative risks. However, tumour size emerged as a significant factor associated with complications, highlighting the need for careful preoperative assessment and planning, particularly in patients with larger tumours.<\/jats:p>","DOI":"10.3390\/medicina60122088","type":"journal-article","created":{"date-parts":[[2024,12,20]],"date-time":"2024-12-20T06:44:33Z","timestamp":1734677073000},"page":"2088","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Risk Factors and Postoperative Complications of Lobectomy for Non-Small Cell Lung Cancer: An Exploratory Analysis of Premedication and Clinical Variables"],"prefix":"10.3390","volume":"60","author":[{"given":"Mark\u00e9ta","family":"Kepi\u010dov\u00e1","sequence":"first","affiliation":[{"name":"Department of Surgery, University Hospital Ostrava, 17. listopadu 1790, 708 52 Ostrava, Czech Republic"},{"name":"Department of Surgical Studies, Faculty of Medicine, University of Ostrava, Syllabova 19, 703 00 Ostrava, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3100-5990","authenticated-orcid":false,"given":"Lubom\u00edr","family":"Tulinsk\u00fd","sequence":"additional","affiliation":[{"name":"Department of Surgery, University Hospital Ostrava, 17. listopadu 1790, 708 52 Ostrava, Czech Republic"},{"name":"Department of Surgical Studies, Faculty of Medicine, University of Ostrava, Syllabova 19, 703 00 Ostrava, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ad\u00e9la","family":"Kond\u00e9","sequence":"additional","affiliation":[{"name":"Department of Applied Mathematics, Faculty of Electrical Engineering and Computer Science, VSB\u2014Technical University of Ostrava, 17. listopadu 2172\/15, 708 00 Ostrava, Czech Republic"},{"name":"Department of Deputy Director for Science, Research and Education, University Hospital Ostrava, 17. listopadu 1790, 708 52 Ostrava, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula","family":"Dzur\u0148\u00e1kov\u00e1","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care Medicine, University Hospital Ostrava, 17. listopadu 1790, 708 52 Ostrava, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Ihn\u00e1t","sequence":"additional","affiliation":[{"name":"Department of Surgery, University Hospital Ostrava, 17. listopadu 1790, 708 52 Ostrava, Czech Republic"},{"name":"Department of Surgical Studies, Faculty of Medicine, University of Ostrava, Syllabova 19, 703 00 Ostrava, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9726-5771","authenticated-orcid":false,"given":"D\u00e1vid","family":"Adamica","sequence":"additional","affiliation":[{"name":"Department of Surgery, University Hospital Ostrava, 17. listopadu 1790, 708 52 Ostrava, Czech Republic"},{"name":"Department of Surgical Studies, Faculty of Medicine, University of Ostrava, Syllabova 19, 703 00 Ostrava, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u010cestm\u00edr","family":"Neoral","sequence":"additional","affiliation":[{"name":"Department of Surgical Studies, Faculty of Medicine, University of Ostrava, Syllabova 19, 703 00 Ostrava, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5186-5651","authenticated-orcid":false,"given":"Lubom\u00edr","family":"Mart\u00ednek","sequence":"additional","affiliation":[{"name":"Department of Surgery, University Hospital Ostrava, 17. listopadu 1790, 708 52 Ostrava, Czech Republic"},{"name":"Department of Surgical Studies, Faculty of Medicine, University of Ostrava, Syllabova 19, 703 00 Ostrava, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,12,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1002\/jso.24532","article-title":"Lung cancer-A global perspective","volume":"115","author":"McIntyre","year":"2017","journal-title":"J. Surg. Oncol."},{"key":"ref_2","unstructured":"(2024, March 21). Cancer Today. Available online: https:\/\/gco.iarc.fr\/."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"8","DOI":"10.5334\/aogh.2419","article-title":"Global Epidemiology of Lung Cancer","volume":"85","author":"Barta","year":"2019","journal-title":"Ann. Glob. Health"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.ccm.2019.10.001","article-title":"Lung Cancer 2020","volume":"41","author":"Bade","year":"2020","journal-title":"Clin. Chest. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1016\/j.cnc.2019.05.002","article-title":"Surgical Treatment of Lung Cancer","volume":"31","author":"Hoy","year":"2019","journal-title":"Crit. Care Nurs. Clin. N. Am."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1016\/j.jss.2020.10.020","article-title":"Comparative Effectiveness of Surgical Approaches for Lung Cancer","volume":"263","author":"Manerikar","year":"2021","journal-title":"J. Surg. Res."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"836","DOI":"10.1016\/S1470-2045(16)00173-X","article-title":"Postoperative pain and quality of life after lobectomy via video-assisted thoracoscopic surgery or anterolateral thoracotomy for early stage lung cancer: A randomised controlled trial","volume":"17","author":"Bendixen","year":"2016","journal-title":"Lancet Oncol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"ezac303","DOI":"10.1093\/ejcts\/ezac303","article-title":"VATS versus open thoracotomy for lung cancer resection: Is the game still running?","volume":"62","author":"Mercier","year":"2022","journal-title":"Eur. J. Cardiothorac. Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3310\/THBQ1793","article-title":"Impact of video-assisted thoracoscopic lobectomy versus open lobectomy for lung cancer on recovery assessed using self-reported physical function: VIOLET RCT","volume":"26","author":"Lim","year":"2022","journal-title":"Health Technol. Assess."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1072","DOI":"10.1016\/j.athoracsur.2019.04.037","article-title":"Video-Assisted Vs Thoracotomy Sleeve Lobectomy for Lung Cancer: A Propensity Matched Analysis","volume":"108","author":"Gao","year":"2019","journal-title":"Ann. Thorac. Surg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"318","DOI":"10.5306\/wjco.v10.i10.318","article-title":"Management of oligometastatic non-small cell lung cancer patients: Current controversies and future directions","volume":"10","author":"Luna","year":"2019","journal-title":"World J. Clin. Oncol."},{"key":"ref_12","unstructured":"Freeman, B.S., and Berger, J.S. (2014). Anesthesiology Core Review. Part 1, Basic Exam, Mcgraw-Hill Education Medical."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"215145932210910","DOI":"10.1177\/21514593221091062","article-title":"Pre-Operative Medications as a Predictor for Post-Operative Complications Following Geriatric Hip Fracture Surgery","volume":"13","author":"McDonald","year":"2022","journal-title":"Geriatr. Orthop. Surg. Rehabil."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1177","DOI":"10.1007\/s40520-018-0904-2","article-title":"Association of pre-operative medication use with post-surgery mortality and morbidity in oncology patients receiving comprehensive geriatric assessment","volume":"30","author":"Choi","year":"2018","journal-title":"Aging Clin. Exp. Res."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Lee, C.-Y., Cheng, Y.-D., Cheng, W.-Y., Tsai, T.-H., and Huang, K.-H. (2020). The Prevalence of Anticholinergic Drugs and Correlation with Pneumonia in Elderly Patients: A Population-Based Study in Taiwan. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17176260"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"7","DOI":"10.2147\/TCRM.S231383","article-title":"Risk Factors of Pulmonary Complications After Minimally Invasive Surgery for Elderly Patients with Vertebral Compression Fractures","volume":"16","author":"Zhang","year":"2020","journal-title":"Ther. Clin. Risk Manag."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"936","DOI":"10.1016\/j.athoracsur.2010.05.014","article-title":"Systematic classification of morbidity and mortality after thoracic surgery","volume":"90","author":"Seely","year":"2010","journal-title":"Ann. Thorac. Surg."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1097\/EJA.0000000000000118","article-title":"Standards for definitions and use of outcome measures for clinical effectiveness research in perioperative medicine","volume":"32","author":"Jammer","year":"2015","journal-title":"Eur. J. Anaesthesiol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1161","DOI":"10.1164\/rccm.200510-1556OC","article-title":"Postoperative Pneumonia after Major Lung Resection","volume":"173","author":"Schussler","year":"2006","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1016\/j.athoracsur.2017.07.032","article-title":"Postoperative Outcome After Pulmonary Surgery for Non-Small Cell Lung Cancer in Elderly Patients","volume":"105","author":"Detillon","year":"2018","journal-title":"Ann. Thorac. Surg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e25295","DOI":"10.1097\/MD.0000000000025295","article-title":"Risk factors for postoperative pneumonia and prognosis in lung cancer patients after surgery","volume":"100","author":"Yao","year":"2021","journal-title":"Medicine"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"3499","DOI":"10.21037\/jtd.2018.05.177","article-title":"Video-assisted thoracoscopic versus open thoracotomy lobectomy: A Swedish nationwide cohort study","volume":"10","author":"Bergman","year":"2018","journal-title":"J. Thorac. Dis."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"3567","DOI":"10.1007\/s00464-021-08680-y","article-title":"Does morbid obesity influence perioperative outcomes after video-assisted thoracic surgery (VATS) lobectomy for non-small cell lung cancer? Analysis of the Italian VATS group registry","volume":"36","author":"Guerrera","year":"2021","journal-title":"Surg. Endosc."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1111\/jgs.13327","article-title":"Anticholinergic Medications and Risk of Community-Acquired Pneumonia in Elderly Adults: A Population-Based Case-Control Study","volume":"63","author":"Paul","year":"2015","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1186\/s13019-020-01305-w","article-title":"Video-Assisted Thoracoscopic Surgery vs Thoracotomy for Non-Small Cell Lung Cancer Greater Than 5 cm: Is VATS a feasible approach for large tumors?","volume":"15","author":"Batihan","year":"2020","journal-title":"J. Cardiothorac. Surg."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1340","DOI":"10.1016\/j.rmed.2015.07.008","article-title":"Risk factors for postoperative pneumonia after lung cancer surgery and impact of pneumonia on survival","volume":"109","author":"Simonsen","year":"2015","journal-title":"Respir. Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"979","DOI":"10.3346\/jkms.2011.26.8.979","article-title":"Risk factors of postoperative pneumonia after lung cancer surgery","volume":"26","author":"Lee","year":"2011","journal-title":"J. Korean Med. Sci."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1177\/0218492312457359","article-title":"Risk factors for postoperative complications in the elderly with lung cancer","volume":"21","author":"Ogawa","year":"2013","journal-title":"Asian Cardiovasc. Thorac. Ann."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1090","DOI":"10.1590\/1806-9282.20220526","article-title":"Obesity in cases undergoing the surgical procedure of lung lobectomy: Risk or benefit?","volume":"68","author":"Sengul","year":"2022","journal-title":"Rev. Assoc. Med. Bras."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1186\/s12893-018-0395-2","article-title":"Obesity paradox in patients undergoing lung lobectomy\u2014Myth or reality?","volume":"18","author":"Ostruszka","year":"2018","journal-title":"BMC Surg."},{"key":"ref_31","first-page":"1259","article-title":"Operative Time Is Associated with Postoperative Complications After Pulmonary Lobectomy","volume":"278","author":"Tan","year":"2022","journal-title":"Ann. Surg."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"ezac503","DOI":"10.1093\/ejcts\/ezac503","article-title":"Operating time: An independent and modifiable risk factor for short-term complications after video-thoracoscopic pulmonary lobectomy","volume":"62","author":"Forcada","year":"2022","journal-title":"Eur. J. Cardiothorac. Surg."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/60\/12\/2088\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:56:16Z","timestamp":1760115376000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/60\/12\/2088"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,20]]},"references-count":32,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["medicina60122088"],"URL":"https:\/\/doi.org\/10.3390\/medicina60122088","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,20]]}}}