RESUMEN
BACKGROUND: Nasal closure, also known as the modified Young's procedure was introduced in Denmark in 2008, as a surgical solution to severe epistaxis in patients with hereditary haemorrhagic telangiectasia (HHT). The objective of this study was to report the overall satisfaction of the procedure from a patient's point of view as well as the occurrence of complications. METHODS: All the HHT patients who underwent nasal closure from 2008 to 2018 were included in the study. The patients were evaluated for postoperative complications and subjective outcome using Glasgow Benefit Inventory (GBI). RESULTS: Ten patients were included in the study and were observed for a mean of 64 months. None of the patients was completely free of complications, and reversal was requested in a single case. Haemoglobin levels rose with an average of 2.8 g/dl. The average GBI score after surgery was 38.05. Nine of ten patients would recommend nasal closure to fellow HHT patients. CONCLUSION: Nasal closure is highly recommended among patients, but due to the rate of postoperative complications, the procedure should be reserved for a carefully selected group of HHT patients.
Asunto(s)
Epistaxis/cirugía , Procedimientos Quírurgicos Nasales/métodos , Nariz/cirugía , Telangiectasia Hemorrágica Hereditaria/cirugía , Adulto , Anciano , Estudios de Cohortes , Dinamarca , Epistaxis/etiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Mucosa Nasal/cirugía , Procedimientos Quírurgicos Nasales/efectos adversos , Medición de Resultados Informados por el Paciente , Satisfacción del Paciente , Colgajos Quirúrgicos/cirugía , Telangiectasia Hemorrágica Hereditaria/complicaciones , Resultado del TratamientoRESUMEN
This article focuses on patients with limited life expectancy who no longer benefit from preventive medication but not yet qualify for palliative care - a time frame often referred to as End-of-Life (EOL). The purpose of this article is to identify and assess international guidelines for prescribing in EOL. No relevant clinical trials were available, but we found advice mainly based on logic assumptions and thoughts. Optimal prescribing for EOL patients remains mostly unexplored. Our study revealed two pivotal questions: How do we identify EOL patients, and what specific drugs should be removed?