157 Chapter 8 these abnormalities were found only in nine out of 20 patients, and no clear distinction was visible between patients with a high anamnestic bleeding tendency and those with a normal anamnestic bleeding tendency. In conclusion, no particular coagulation disorder associated with OI was found to explain bleeding tendency, but different components of coagulation may be abnormal. It is therefore advised that bleeding tendency should be explicitly asked about before surgeries, that coagulation should be monitored in the laboratory in the case of increased bleeding tendency, and that regardless of the outcome, a possible increased bleeding risks should be closely monitored. Chapter 7 summarizes and discusses the results, providing recommendations for future research and clinical practice. It is important that a multidisciplinary, individualistic, and holistic approach is followed in the care for individuals with OI, and interventions need to be chosen in collaboration with the patient and focused on improving the quality of life. As quality of life can vary at different ages, it is important to assess quality of life regularly. Further research is necessary to fully understand the various dimensions of quality of life in individuals with OI. Furthermore, bleeding tendency is a common complication in adults with OI and can be a significant clinical challenge. The underlying pathophysiology of bleeding tendency in OI is not well understood and further research is needed. The management of bleeding episodes in OI patients requires an individualized approach, and in this context the use of antifibrinolytics and coagulation factors may be helpful.
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