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Epidemiological survey of the orthopaedic status of severe haemophilia A and B patients in France
Author(s) -
P Molho,
N Rolland,
T Lebrun,
G Dirat,
Jean-Pierre Courpied,
Thérèse Croughs,
I. Duprat,
Sultan Y
Publication year - 2000
Publication title -
haemophilia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.213
H-Index - 92
eISSN - 1365-2516
pISSN - 1351-8216
DOI - 10.1046/j.1365-2516.2000.00358.x
Subject(s) - medicine , haemophilia , quality of life (healthcare) , physical therapy , haemophilia a , epidemiology , vitality , orthopedic surgery , cross sectional study , pediatrics , family medicine , surgery , philosophy , nursing , theology , pathology
One hundred and 16 patients contributed to an analysis of the impact of the consequences of severe haemophilia A or B (factor levels < 2%) on orthopaedic status, resources consumed in relation to this status and resultant cost, and quality of life as perceived by the patient, using the MOS 36‐Item‐Short‐Form Health Survey (SF‐36). This French cross‐sectional study involved outpatients regularly attending a haemophilia treatment centre. Data were collected retrospectively over a period of 1 year by the physician of the haemophilia treatment centre. Patients had a mean age of 23, and consisted of 50% students, 25% salaried workers, 17.2% with no professional activity and 7.8% physically impaired; 82.8% of them had type A haemophilia. Mean pain score was 2.5 per patient for the six main joints; 7.7 for the clinical score and 18.8 for the radiological score, with a mean number of bleeds of 16.3 per year per patient. During the year prior to inclusion, and because of their orthopaedic status, 22.4% of patients were hospitalized, 76.7% attended for an outpatient visit and 76.7% required at least one special investigation; 97.4% received replacement therapy, 41.4% required treatment for joint pain and 42.2% orthopaedic equipment. The less affected dimensions were the physical function (76.8 ± 22.2) and the social relations (76.1 ± 23.1). Least good quality of life scores concerned the pain (60.2 ± 25.2), perception of general health (59.3 ± 23.1) and vitality (57.8 ± 19.5) dimensions. The age was a discriminant criterion since quality of life was better in patients of the 18–23 age group for five dimensions. Mean annual treatment costs of a patient with severe haemophilia were determined as 425 762 French francs ($73 029). Loss of production was estimated at a mean of 4609 French francs ($791) per active patient over the course of the year. Results showed indirect evidence of the usefulness of early home treatment.