The silent foe: Agranulocytosis-related mortality in the United States from 1999 to 2023: Insights from the CDC wonder database

Abstract The Silent Foe: Agranulocytosis-Related Mortality in the United States from 1999 to 2023: Insights from the CDC Wonder Database Introduction: Agranulocytosis, diagnosed when the Absolute Neutrophil Count (ANC) is less than 100 cells per microliter of blood can make individuals susceptible to serious-life threatening infections. Rarely, it can be inherited with more common reasons being medications, bone marrow disorders and auto-immune diseases. Methods: Age-adjusted Mortality Rates (AAMRs) per 100,000 in adults (25+) were obtained from the CDC WONDER using ICD-10 Codes for Agranulocytosis (D70). Joinpoint regression estimated Annual percent Change and average APC, with significance at p<0.05. Results: From 1999 to 2023 72,005 Agranulocytosis related deaths occurred among adults (25+). The overall AAMR fell slightly from 1.5 in 1999 to 1.3 in 2023(AAPC: -0.2; 95% CI -0.7-0.2, p = 0.337171). Males accounted for 53.3% % of deaths. Males had slightly higher AAMR than females (1.5 % vs 1.1 %), with males exhibiting a fall (AAPC: -0.5%; 95% CI: -1.0 to -0.03, p=0.037444). NH Blacks had the highest AAMR (1.3) as well as the sharpest decline in mortality (AAPC: -1.0; 95% CI: -2.3 to 0.1, p=0.080026). Mortality was comparable in both urban and rural areas (1.2 vs 1.4) with similar AAPCs (-0.31% vs -0.29%). The Northeast had the highest AAMR (1.3), with also the steepest decline in AAPC (AAPC: -1.0; 95% CI: -1.3 to -0.4,p=0.0012). States with the highest mortality include Washington, Nebraska and North Dakota while Louisiana, Michigan and Florida ranked the lowest. Conclusion: Agranulocytosis related deaths have fallen slightly due to more advancements in diagnosis, better pharmacotherapy and earlier interventions. However, the fall has been slow and disparities still exist among men, NH Blacks, rural areas and States such as Washington. Targeted interventions are needed to curb mortality of this life-threatening disorder.