What are the acute causes of death in aplastic anemia?

In general, acute causes of death in patients with aplastic anemia include severe intracranial hemorrhage, severe pulmonary infection, acute massive gastrointestinal bleeding, sepsis, and severe heart failure. Detailed explanations are as follows:

1. Severe Intracranial Hemorrhage

Patients with aplastic anemia suffer from bone marrow hematopoietic failure, resulting in severely reduced platelet production and abnormal coagulation function. When the platelet count is extremely low, cerebral blood vessels are prone to rupture and bleed even with minor injury. Accumulated blood within the skull compresses brain tissue, causing a rapid increase in intracranial pressure, which may lead to coma, respiratory arrest, and cardiac arrest. Without prompt rescue, this can result in death within a short time.

2. Severe Pulmonary Infection

These patients have reduced white blood cell production, especially neutropenia, leading to a significant decline in the body's ability to fight infections. The lungs are vulnerable to invasion by pathogens such as bacteria, viruses, and fungi. When infection rapidly progresses to severe pneumonia, it causes serious lung damage and respiratory failure, resulting in systemic hypoxia. If the infection cannot be effectively controlled, it becomes life-threatening.

3. Acute Massive Gastrointestinal Bleeding

Due to platelet deficiency and impaired production of clotting factors, the gastrointestinal mucosa may experience spontaneous bleeding or massive hemorrhage from minor injuries. If bleeding is rapid and extensive, it can quickly lead to hemorrhagic shock, insufficient organ perfusion, multi-organ dysfunction, and ultimately death.

4. Sepsis

Patients have severely compromised immune function, making skin and mucosal defense barriers easily breached by pathogens. Once pathogens enter the bloodstream, they multiply rapidly and release toxins, causing sepsis. These toxins can damage multiple organs throughout the body, leading to multiple organ dysfunction syndrome (MODS). The condition progresses rapidly and has a high mortality rate.

5. Severe Heart Failure

Chronic anemia leads to persistent myocardial hypoxia and impaired heart muscle function. If patients also experience severe infections or massive bleeding, the burden on the heart increases significantly. Under the combined effects of these factors, the heart may fail to maintain normal pumping function, resulting in severe heart failure, circulatory collapse, and ultimately death.

In addition, patients with aplastic anemia should also be vigilant for complications such as urinary tract bleeding and retinal hemorrhage. Daily precautions include avoiding trauma, maintaining personal hygiene, and minimizing infection risks. Immediate medical attention is required if symptoms such as dizziness, vomiting blood, coughing up blood, or high fever occur. Timely intervention and treatment can reduce the risk of acute death.