A PROSPECTIVE-STUDY OF PATTERNS OF BLEEDING IN BOYS WITH HEMOPHILIA

To describe the patterns of bleeding and clotting factor concentrate u se in boys with haemophilia over a 6-month period, daily diary records of bleeding, factor use, levels of physical activity, chore performan ce and school attendance were collected from parents of 96 males betwe en 4 and 17 rears of age with haemophilia A or B followed at six compr ehensive haemophilia treatment centres in Massachusetts, Rhode Island and Tennessee. 14 243 person days were available for analysis. The sam ple cohort averaged approximately nine bleeding episodes (1.5 per mont hs), almost two-thirds of which were haemarthroses. 44% of bleeds were associated with injury and the average duration was 1.4 days. New ble eding episodes were significantly more likely to begin on weekdays (Mo nday-Thursday) than on weekends (Friday-Sunday). Boys with more severe disease had significantly more bleeding episodes and a higher frequen cy of haemarthroses. Boys with the most severe disease were also more likely to have joints involved when they bled and to have more spontan eous bleedings without apparent preceding trauma. Bleeding was associa ted with increased school absence, decreased levels of physical activi ty and decreased rates of household task performance. Relatively high rates of bleeding associated with trauma suggest the need for preventi ve interventions.