Von Willebrand Disease in Older Patients: A Retrospective Electronic Health Record Review

Von Willebrand disease (VWD) is often diagnosed as a consequence of symptoms experienced with hemostatic stressors, such as menstruation and childbirth. Thus, patients seeking medical care for VWD are generally younger. As a result, the natural course of VWD in older adults has not been well describ...

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Bibliographic Details
Published in:Clinical and applied thrombosis/hemostasis 2022-01, Vol.28, p.10760296221146740-10760296221146740
Main Author: Seaman, Craig D.
Format: Article
Language:English
Subjects:
Comorbidity
Electronic Health Records
Hemorrhage
Humans
Middle Aged
Older people
Original Manuscript
Retrospective Studies
von Willebrand Diseases - epidemiology
von Willebrand Factor - analysis
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Summary:Von Willebrand disease (VWD) is often diagnosed as a consequence of symptoms experienced with hemostatic stressors, such as menstruation and childbirth. Thus, patients seeking medical care for VWD are generally younger. As a result, the natural course of VWD in older adults has not been well described. A retrospective electronic health record review was performed to provide a descriptive analysis of older VWD patients with at least one clinic visit at the Hemophilia Center of Western Pennsylvania (HCWP) between June 1, 2015, and May 31, 2021, and age 45 or older at the time of the visit. Data collected included VWD-related information, multimorbidity, and medications. Age-related change in von Willebrand factor (VWF) levels and the influence of multimorbidity on VWF levels were assessed. Seventy patients had 131 HCWP clinic visits. Hypertension, 34.3%, and osteoarthritis, 32.3%, were the most common multimorbidity-associated conditions. More than 33% of patients were receiving at least one antihemostatic medication. The most common bleeding symptom was ecchymosis, 22.9%. VWF antigen levels, 0.76 IU/mL, and the proportion of patients with normal VWF levels, 54.5%, increased with age to 0.99 IU/mL, p < 0.001, and 78.8%, p 
ISSN:1076-0296
1938-2723
DOI:10.1177/10760296221146740