Data Sheet 1_Longitudinal sepsis-induced coagulopathy score trajectories and mortality in relation to early prophylactic heparin: a multicentre cohort study.docx

Relative to the Resolving trajectory, adjusted subdistribution hazard ratios (sHR) for mortality were 1.65 (95% CI 1.52–1.78) and 1.33 (1.18–1.49) for Persistently High and Rising-then-Falling in MIMIC-IV, and 1.73 (1.51–1.99) and 1.67 (1.33–2.11) 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 0.839–0.983, P = 0.018); 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 0.744–1.034, P = 0.118).</p>Conclusion<p>SIC score trajectories stratify septic patients into three trajectory classes—Persistently High, Rising-then-Falling, and Resolving—each 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.</p>