Trends in aplastic anemia mortality among older adults with sepsis in the United States, 1999–2024: A CDC wonder database analysis

Abstract Background: Aplastic anemia is a rare but life-threatening hematologic disorder, with sepsis often acting as a critical contributing factor in patient outcomes. This study investigates national mortality trends of aplastic anemia among older adults (aged 65 and above) with sepsis in the United States from 1999 to 2024. Methods: Data were extracted from the CDC WONDER Multiple Cause of Death database. Adults aged 65 and older with aplastic anemia as the underlying cause of death and sepsis as a contributing condition were included. Age-adjusted mortality rates (AAMRs) per 1000,000 population were calculated, and Joinpoint regression was used to determine annual percent changes (APCs). Results: A total of 3,828 deaths were identified. The AAMR declined significantly by 50%, from 4.8 in 1999 to 2.8 in 2024 (APC: –1.64%). Males exhibited a higher AAMR (3.8) compared to females (3.2). Non-Hispanic Whites had the highest AAMR among racial/ethnic groups (3.3). Mortality rates were higher in non-metropolitan areas (3.6) and in the South region (3.9). Conclusions: Aplastic anemia mortality among older adults with sepsis has declined significantly over the past two decades. However, notable disparities persist across sex, region, and urbanization levels, warranting targeted public health strategies.