Prospective audit of patients with haemophilia: Bleeding episodes and management

BACKGROUND: Haemophilia is a congenital bleeding disorder that requires replacement of factor VIII (haemophilia A) or factor IX (haemophilia B) via intravenous infusions. Children can either be treated with prophylactic treatment to prevent bleeding or be managed with on-demand therapy and treat specific bleeding episodes. AIMS: The aim of this paper was to prospectively follow a cohort of haemophilia patients to determine the incidence of bleeding, re-bleeding, re-treatment and adjunct management over a period of 5 months. METHODS: Sixty-six boys with haemophilia were followed. Age range was 10 months to 19 years; 70% of patients had severe haemophilia and 38 (58%) of all patients were on prophylaxis. RESULTS: Twenty-nine patients experienced at least one episode of bleeding during study period which included 70 home bleeding episodes and 20 emergency department (ED) presentations. Secondary treatments occurred in 38% of all bleeding episodes. The incidence of re-bleeds occurring within 3 weeks of the initial bleeding episode was 11%. CONCLUSIONS: Further study focusing on optimising treatment regimes for patients with haemophilia presenting with bleeding episodes is necessary.