{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T05:01:32Z","timestamp":1790226092405,"version":"4.1.0"},"reference-count":38,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:00:00Z","timestamp":1790208000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cell. Infect. Microbiol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Sepsis-induced coagulopathy (SIC) evolves dynamically, and a single-timepoint score may not capture its longitudinal course. This study characterised SIC score trajectories, evaluated their associations with mortality, and conducted exploratory analyses of early prophylactic unfractionated heparin exposure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>SIC score trajectories were characterised using a latent class mixed model. Trajectory-class prediction models were developed from baseline features within the first 24 hours of ICU admission using five algorithms. Heparin analysis used a 48-hour landmark design; weighted Fine\u2013Gray models and cumulative incidence functions estimated 28-day post-landmark in-hospital mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The study enrolled 20,168 patients from MIMIC-IV and 5,829 from eICU-CRD. Three SIC trajectories were identified\u2014Persistently High, Rising-then-Falling, and Resolving\u2014comprising 31.9%, 10.6%, and 57.5% of patients in MIMIC-IV and 49.1%, 7.2%, and 43.7% in eICU-CRD. Relative to the Resolving trajectory, adjusted subdistribution hazard ratios (sHR) for mortality were 1.65 (95% CI 1.52\u20131.78) and 1.33 (1.18\u20131.49) for Persistently High and Rising-then-Falling in MIMIC-IV, and 1.73 (1.51\u20131.99) and 1.67 (1.33\u20132.11) in eICU-CRD. Prophylactic heparin was associated with a lower subdistribution hazard of 28-day post-landmark mortality in MIMIC-IV (sHR=0.908, 95% CI 0.839\u20130.983, P\u00a0=\u00a00.018); in an exploratory interaction analysis, the point estimate was more pronounced at higher predicted probabilities of the Persistently High trajectory, but this pattern was not replicated in eICU-CRD (sHR 0.877, 95% CI 0.744\u20131.034, P\u00a0=\u00a00.118).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>SIC score trajectories stratify septic patients into three trajectory classes\u2014Persistently High, Rising-then-Falling, and Resolving\u2014each showing a graded association with 28-day mortality. Early prophylactic unfractionated heparin showed an exploratory association with lower post-landmark mortality in MIMIC-IV that was not independently replicated in eICU-CRD. Although these findings do not support treatment recommendations or trajectory-based anticoagulation decisions, they provide a basis for formulating hypotheses for future prospective studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcimb.2026.1923833","type":"journal-article","created":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T04:31:08Z","timestamp":1790224268000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Longitudinal sepsis-induced coagulopathy score trajectories and mortality in relation to early prophylactic heparin: a multicentre cohort study"],"prefix":"10.3389","volume":"16","author":[{"given":"Yuan","family":"Cao","sequence":"first","affiliation":[{"name":"Medical School of Chinese PLA","place":["Beijing, China"]},{"name":"Department of Critical Care Medicine, the First Medical Centre, Chinese PLA General Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Wang","sequence":"additional","affiliation":[{"name":"Medical School of Chinese PLA","place":["Beijing, China"]},{"name":"Department of Critical Care Medicine, the First Medical Centre, Chinese PLA General Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun","family":"Li","sequence":"additional","affiliation":[{"name":"Medical Intensive Care Unit, General Hospital of Southern Theater Command of PLA, Guangzhou","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaoqing","family":"Shi","sequence":"additional","affiliation":[{"name":"Medical School of Chinese PLA","place":["Beijing, China"]},{"name":"Department of Critical Care Medicine, the First Medical Centre, Chinese PLA General Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chengjin","family":"Wang","sequence":"additional","affiliation":[{"name":"Medical School of Chinese PLA","place":["Beijing, China"]},{"name":"Department of Critical Care Medicine, the First Medical Centre, Chinese PLA General Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiqi","family":"Wu","sequence":"additional","affiliation":[{"name":"Medical School of Chinese PLA","place":["Beijing, China"]},{"name":"Department of Critical Care Medicine, the First Medical Centre, Chinese PLA General Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhen","family":"Gao","sequence":"additional","affiliation":[{"name":"Medical School of Chinese PLA","place":["Beijing, China"]},{"name":"Department of Critical Care Medicine, the First Medical Centre, Chinese PLA General Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lu","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Fifth Medical Centre of Chinese PLA General Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuyan","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Chinese PAP Beijing Corps Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongjun","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, the First Medical Centre, Chinese PLA General Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,24]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"756","DOI":"10.1007\/s00134-025-07873-6","article-title":"Sepsis subphenotypes, theragnostics and personalized sepsis care","volume":"51","author":"Antcliffe","year":"2025","journal-title":"Intensive Care Med."},{"key":"B2","doi-asserted-by":"publisher","first-page":"790","DOI":"10.1056\/NEJMoa2105911","article-title":"Therapeutic anticoagulation with heparin in noncritically ill patients with covid-19","volume":"385","year":"2021","journal-title":"N. 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