{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T16:15:27Z","timestamp":1777479327512,"version":"3.51.4"},"reference-count":34,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Clin Appl Thromb Hemost"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Due 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We identified geriatric sepsis patients (aged \u226565 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A 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) (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Early administration UFH to geriatric patients with sepsis was associated with reducing ICU mortality, without increasing the risk of bleeding. Subgroup analysis further suggested that UFH therapy conferred organ protective effects, particularly pronounced in patients requiring mechanical ventilation and those with AKI.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10760296251386049","type":"journal-article","created":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T17:34:41Z","timestamp":1759944881000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Heparin Therapy was Associated with the Reduction of ICU Mortality in Geriatric Patients with Sepsis: A Retrospective Cohort Study"],"prefix":"10.1177","volume":"31","author":[{"given":"Zong-fang","family":"Ren","sequence":"first","affiliation":[{"name":"Department of Medical Critical Care Medicine, General Hospital of Southern Theatre Command of Peoples Liberation Army, Guangzhou, China"},{"name":"Department of Critical Care Medicine, the Second Affiliated Hospital of Kunming Medical University, Kunming, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jia-jia","family":"Huang","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, Shenzhen People's Hospital (the Second Clinical Medical College, Jinan University; the First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kai","family":"Xin","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Huizhou First People's Hospital, Huizhou, China"},{"name":"Department of Infection and Critical Care Medicine, Shenzhen Second People's Hospital &amp; First Affiliated Hospital of Shenzhen University, Shenzhen, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhen-jia","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Da-zheng","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Infection and Critical Care Medicine, Shenzhen Second People's Hospital &amp; First Affiliated Hospital of Shenzhen University, Shenzhen, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu-hua","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Infection and Critical Care Medicine, Shenzhen Second People's Hospital &amp; 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