Abstract：
BACKGROUND: Elderly people with haemophilia (PwH) develop haemophilic arthropathy, pain, and reduced health-related quality of life (HR-QoL). The condition of elderly mild haemophilia patients have rarely been evaluated. This study aimed to compare joint status, pain, and HR-QoL between elderly with mild, moderate/severe haemophilia and healthy elderlies.
METHODS: Knee/ankle abnormalities were assessed by ultrasound (HEAD-US) and physical examination (HJHS 2.1). Pain severity and pain interference were investigated using the Brief Pain Inventory. Pressure pain thresholds (PPTs) were obtained at knees/ankles and forehead. Functional limitations were evaluated using the 2-Minute-Walking-Test, Timed-Up-and-Go and HAL. The EQ-5D-5L questionnaire evaluated HR-QoL. Healthy controls (HCs) and elderly individuals with moderate/severe and mild haemophilia were compared using Kruskal-Wallis and Mann-Whitney U tests.
RESULTS: From the 46 elderly PwH approached, 40 individuals (≥60 years) with haemophilia A/B (17 moderate/severe; 23 mild) and 20 age-matched HCs were recruited. Moderate/severe PwH displayed worse joint status, lower PPTs, and poorer HR-QoL than mild PwH and HCs (p-value = .010-<.001). HEAD-US abnormalities were observed in 100% of knees and 94% of ankles in moderate/severe PwH, versus 50% of knees and 61% of ankles in mild PwH. Pain was reported by 80% and 57% of moderate/severe and mild PwH, respectively. Low PPTs, functional limitations, and poor HR-QoL scores were likewise observed in some mild PwH, yet without significantly differing from HCs.
CONCLUSIONS: This study highlights poor joint/functional status, pain, and HR-QoL outcomes in elderly with moderate/severe haemophilia. A few mild haemophilia subjects presented joint abnormalities, pain, functional limitations, and poor HR-QoL, without significantly differing from HCs.
CONCLUSIONS: Elderly individuals with mild haemophilia have not yet been extensively studied, whereas moderate/severe haemophilia individuals have proven to suffer from haemophilic arthropathy, pain, and poor health-related quality of life (HR-QoL). Using a case-control design, joint status, pain, and HR-QoL outcomes were examined in elderly haemophilia individuals and compared with those of healthy controls (HCs). Elderly moderate/severe haemophilia individuals exhibited worse joint status, increased joint pain sensitivity, and reduced HR-QoL compared with both mild haemophilia subjects and HCs. A subset of mild haemophilia subjects exhibited poor joint status, pain, and HR-QoL outcomes, without any differences noted when compared with HCs.
METHODS: Knee/ankle abnormalities were assessed by ultrasound (HEAD-US) and physical examination (HJHS 2.1). Pain severity and pain interference were investigated using the Brief Pain Inventory. Pressure pain thresholds (PPTs) were obtained at knees/ankles and forehead. Functional limitations were evaluated using the 2-Minute-Walking-Test, Timed-Up-and-Go and HAL. The EQ-5D-5L questionnaire evaluated HR-QoL. Healthy controls (HCs) and elderly individuals with moderate/severe and mild haemophilia were compared using Kruskal-Wallis and Mann-Whitney U tests.
RESULTS: From the 46 elderly PwH approached, 40 individuals (≥60 years) with haemophilia A/B (17 moderate/severe; 23 mild) and 20 age-matched HCs were recruited. Moderate/severe PwH displayed worse joint status, lower PPTs, and poorer HR-QoL than mild PwH and HCs (p-value = .010-<.001). HEAD-US abnormalities were observed in 100% of knees and 94% of ankles in moderate/severe PwH, versus 50% of knees and 61% of ankles in mild PwH. Pain was reported by 80% and 57% of moderate/severe and mild PwH, respectively. Low PPTs, functional limitations, and poor HR-QoL scores were likewise observed in some mild PwH, yet without significantly differing from HCs.
CONCLUSIONS: This study highlights poor joint/functional status, pain, and HR-QoL outcomes in elderly with moderate/severe haemophilia. A few mild haemophilia subjects presented joint abnormalities, pain, functional limitations, and poor HR-QoL, without significantly differing from HCs.
CONCLUSIONS: Elderly individuals with mild haemophilia have not yet been extensively studied, whereas moderate/severe haemophilia individuals have proven to suffer from haemophilic arthropathy, pain, and poor health-related quality of life (HR-QoL). Using a case-control design, joint status, pain, and HR-QoL outcomes were examined in elderly haemophilia individuals and compared with those of healthy controls (HCs). Elderly moderate/severe haemophilia individuals exhibited worse joint status, increased joint pain sensitivity, and reduced HR-QoL compared with both mild haemophilia subjects and HCs. A subset of mild haemophilia subjects exhibited poor joint status, pain, and HR-QoL outcomes, without any differences noted when compared with HCs.
摘要：
背景：患有血友病（PwH）的老年人发展为血友病性关节病，疼痛,与健康相关的生活质量(HR-QoL)降低。很少评估老年轻度血友病患者的病情。本研究旨在比较关节状态，疼痛,和轻度老年人之间的HR-QoL，中度/重度血友病和健康的老人。
方法：通过超声（HEAD-US）和体格检查（HJHS2.1）评估膝/踝异常。使用简明疼痛量表调查疼痛严重程度和疼痛干扰。在膝盖/脚踝和前额获得压力疼痛阈值（PPTs）。使用2分钟步行测试评估功能限制，定时上行和HAL。EQ-5D-5L问卷评估HR-QoL。使用Kruskal-Wallis和Mann-WhitneyU检验比较了健康对照（HCs）和患有中度/重度和轻度血友病的老年人。
结果：从46名老年人PwH走近，招募了40名（≥60岁）A/B血友病（17名中度/重度；23名轻度）和20名年龄匹配的HCs。中度/重度PwH显示更差的关节状态，较低的PPTs,HR-QoL比轻度PwH和HCs更差（p值=.010-<.001）。在中度/重度PwH中，100％的膝盖和94％的脚踝观察到头部-US异常，在轻度PwH中，50％的膝盖和61％的脚踝。80%和57%的中度/重度和轻度PwH报告疼痛，分别。PPTs低,功能限制，在一些轻度PwH中同样观察到较差的HR-QoL评分，但与HC没有显著差异。
结论：本研究强调关节/功能状态差，疼痛,老年中度/重度血友病患者的HR-QoL结局。一些轻度血友病患者出现关节异常，疼痛,功能限制，和可怜的HR-QoL，与HC没有显著差异。
结论：患有轻度血友病的老年人尚未得到广泛研究，而中度/重度血友病个体已被证明患有血友病性关节病，疼痛,健康相关生活质量(HR-QoL)较差。使用病例控制设计，联合状态，疼痛,在老年血友病个体中检查HR-QoL结局,并与健康对照(HCs)进行比较.老年中度/重度血友病个体表现出更差的关节状态，增加关节疼痛敏感性，与轻度血友病受试者和HCs相比，HR-QoL降低。轻度血友病受试者的子集表现出不良的关节状态，疼痛,和HR-QoL结果，与HC相比没有任何差异。
方法：通过超声（HEAD-US）和体格检查（HJHS2.1）评估膝/踝异常。使用简明疼痛量表调查疼痛严重程度和疼痛干扰。在膝盖/脚踝和前额获得压力疼痛阈值（PPTs）。使用2分钟步行测试评估功能限制，定时上行和HAL。EQ-5D-5L问卷评估HR-QoL。使用Kruskal-Wallis和Mann-WhitneyU检验比较了健康对照（HCs）和患有中度/重度和轻度血友病的老年人。
结果：从46名老年人PwH走近，招募了40名（≥60岁）A/B血友病（17名中度/重度；23名轻度）和20名年龄匹配的HCs。中度/重度PwH显示更差的关节状态，较低的PPTs,HR-QoL比轻度PwH和HCs更差（p值=.010-<.001）。在中度/重度PwH中，100％的膝盖和94％的脚踝观察到头部-US异常，在轻度PwH中，50％的膝盖和61％的脚踝。80%和57%的中度/重度和轻度PwH报告疼痛，分别。PPTs低,功能限制，在一些轻度PwH中同样观察到较差的HR-QoL评分，但与HC没有显著差异。
结论：本研究强调关节/功能状态差，疼痛,老年中度/重度血友病患者的HR-QoL结局。一些轻度血友病患者出现关节异常，疼痛,功能限制，和可怜的HR-QoL，与HC没有显著差异。
结论：患有轻度血友病的老年人尚未得到广泛研究，而中度/重度血友病个体已被证明患有血友病性关节病，疼痛,健康相关生活质量(HR-QoL)较差。使用病例控制设计，联合状态，疼痛,在老年血友病个体中检查HR-QoL结局,并与健康对照(HCs)进行比较.老年中度/重度血友病个体表现出更差的关节状态，增加关节疼痛敏感性，与轻度血友病受试者和HCs相比，HR-QoL降低。轻度血友病受试者的子集表现出不良的关节状态，疼痛,和HR-QoL结果，与HC相比没有任何差异。
