ArticleClinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis
Heparin Therapy was Associated with the Reduction of ICU Mortality in Geriatric Patients with Sepsis: A Retrospective Cohort Study.
Article in Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
BackgroundDue to age-related immunosenescence, the efficacy of unfractionated heparin (UFH) in geriatric sepsis populations remains unclear. The aim of this study was to investigate the efficacy of UFH in geriatric sepsis patients, providing a basis for the design of interventional randomized controlled trials.MethodsWe identified geriatric sepsis patients (aged ≥65 years) from the Medical Information Mart for Intensive Care (MIMIC-IV) database, Propensity score matching (PSM) and marginal structural Cox model (MSCM) were used to adjust for both baseline and time varying confounding. The primary endpoint was intensive care unit (ICU) mortality, while secondary outcomes included 28-day, 90-day, and in-hospital mortality, along with haemorrhage occurrence.ResultsA total of 3866 geriatric sepsis patients were enrolled in the study, with 1434 patients receiving UFH therapy. UFH therapy significantly reduced in-ICU mortality (hazard ratio [HR] 0.64, 95% confidence interval [CI] 0.48-0.81) and haemorrhage occurrence (HR 0.43, 95% CI 0.33-0.56) with PSM. However,UFH therapy did not significantly improve 28-day, 90-day, or in-hospital mortality. MSCMs further confirmed that UFH administration reduced ICU mortality (HR 0.58, 95% CI: 0.44-0.75) in the general population. Stratification analysis using MSCMs indicated that UFH administration was associated with a reduced ICU mortality rate among patients on ventilation (HR 0.55, 95% CI 0.41-0.74) and with acute kidney injury (AKI) (HR 0.59, 95% CI 0.45-0.78) (
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