PB0639 - Haemophilia; Ageing and Frailty

Background: Frailty refers to an individual’s resilience to withstand health insults. Identification of frailty allows intervention, resulting in improved health resilience in the general population.

Aims: To assess frailty in a cohort of people with haemophilia (PWH) >50years.

Methods: Electronic health records of all PWH >50years at our Centre were reviewed. Data were collected on comorbidities, medications, Haemophilia Activities List score (HAL), Haemophilia Joint Health Score (HJHS). Rockwood Frailty Score (RFS) was estimated if detail allowed. PWH were stratified into 2 groups: 50-65 years and >65years.

Results: Records of 117 patients were reviewed: 63 were 50-65years (median 56 years; 27/7/29 with severe/moderate/mild haemophilia respectively); 54 were >65years (median 72 years; 5/4/45 with severe/moderate/mild haemophilia respectively). Although the younger group had higher rates of hepatitis C (84% vs 39%) and arthropathy (59% vs 35%), hypertension was common and the leading comorbidity in the older group (37% vs 59%). Cardiovascular comorbidities were frequent including atrial fibrillation 6% (50-65years) and 13% (>65years). Median number of comorbidites in both groups was 2 (range 0-7); 14% patients 50-65years and 4% >65years had no comorbidity. HAL and HJHS was only known for those with severe and moderate haemophilia, and median scores were similar between the cohorts. The RFS could be calculated for 87 PWH; the proportion with significant frailty (RFS >3) was 17% (50-65years) and 29% (>65years).

Conclusion(s): This retrospective analysis demonstrates that at our Centre PWH >50years already show significant comorbidities, in particular hypertension and atrial fibrillation. The higher rates of hepatitis C and arthropathy in the younger group were likely due to the higher proportion with severe haemophilia. The British Geriatric Society estimates 10% of people >65years live with frailty, and both groups in our study show relatively increased frailty. This supports the need for future prospective studies to assess frailty in haemophilia and the potential impact of interventions.