Egyptian Rheumatology and Rehabilitation (Mar 2022)
Quality of life and clinical assessment of joint health in children with hemophilic arthropathy
Abstract
Abstract Background Hemophilic arthropathy results in pain, deformity, and disability with severe impairments, activity limitation, and thus productivity loss. Also patterns of treatment interfere with patients’ life, so the quality of life should be assessed when evaluating treatment. The aim of this work was to assess the quality of life of children with hemophilic arthropathy and its relation to clinical joint health. Results The study was carried out on fifty boys with hemophilic arthropathy. All patients were subjected to thorough local clinical assessment of the most affected and/or target joint using Hemophilia Joint Health Score (HJHS 2.1) and assessment of quality of life using Haemo quality of life (Haemo-Qol) questionnaire children and parent versions. Among the fifty hemophilic patients, 36 (72%) patients were hemophilia A and 14 (28 %) patients were hemophilia B. The age at first hemarthrosis ranged from 1 to 8 years with a mean of 2.40±1.78. While the number of joints affected in the studied patients ranged from 2 to 13 joints with a mean of 7±3.25. As regards the severity, 23 patients (46%) had severe, and 27 (54%) had moderate hemophilia. Forty four (88%) patients had different degrees of anemia. There was significant correlation between child Haemo-QoL with degree of anemia (r = 0.291, P = 0.040), mainly with view and school dimensions. There were significant correlations between child and parent Haemo-QoL and HJHS with each of the following: factor activity level, duration of the disease, duration of joint disease, number of bleeding attacks last year, and number of joints affected. Synovectomy was done for 5 (10%) patients. The total child Haemo-QoL score was statistically significantly lower after the intervention (P=0.043), with a significant improvement in physical health, feeling, view, family, school and sports, treatment, and dealing dimensions. In the current study, there were significant positive correlations between child and parent Haemo-QoL and HJHS scores. Conclusions The quality of life in patients with hemophilic arthropathy was influenced by the joint health, factor activity level, disease duration, number of bleeding attacks, number of joints affected (during life), duration of joint disease, and presence of hepatitis C virus.
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