Early prophylactic heparin use is associated with reduced mortality in patients with non-traumatic subarachnoid hemorrhage.

Overview

1. School of Medicine, South China University of Technology, Guangzhou, China
2. Department of Clinical Pharmacy, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
3. Center of Medical Big Data, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
4. Guangdong Provincial Key Laboratory of Artificial Intelligence in Medical Image Analysis and Application, Guangzhou, China

Abstract

Background: Heparin may mitigate secondary brain injury in subarachnoid hemorrhage (SAH), but its effect on survival in non-traumatic SAH (NSAH) remains uncertain. This study aimed to investigate the association between early prophylactic heparin use (within 72 h of admission) and mortality outcomes in patients with NSAH.

Methods: We performed a retrospective cohort study using the Medical Information Mart for Intensive Care (MIMIC) and the eICU Collaborative Research Database (eICU-CRD). Patients were stratified by early heparin use. Cox models, Kaplan–Meier (KM) curves, subgroup analyses, and comprehensive propensity score–based sensitivity analyses were applied to assess the robustness of the observed associations. The primary outcome was in-hospital mortality; 28-, 90-, 180-, and 365-day mortality were secondary outcomes. Findings were validated using the eICU-CRD cohort.

Results: In the MIMIC-IV cohort, early heparin use was associated with lower in-hospital mortality (HR 0.62, 95% CI 0.39–0.97, p = 0.037), which was confirmed in the eICU-CRD cohort (HR 0.47, 95% CI 0.22–1.00, p = 0.049). Consistent reductions were also observed for 28-day (HR 0.57, p = 0.009), 90-day (HR 0.62, p = 0.010), 180-day (HR 0.63, p = 0.009), and 365-day mortality (HR 0.61, p = 0.004) in the MIMIC-IV cohort. Subgroup analyses and KM curves further supported these findings. Propensity score-based sensitivity analyses further validated the robustness of these findings in both cohorts.

Conclusion: Early prophylactic heparin was associated with lower risk-adjusted short- and long-term mortality in NSAH.

Reproduced under the paper's license (CC BY), from the paper cited above.

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Data

Datasets cited

• physionet.org/content/eicu-crd-demo, at PhysioNet; found in “Data availability statement”
• physionet.org/content/mimiciv, at PhysioNet; found in “Data availability statement”

Data availability statement

Publicly available datasets were analyzed in this study. This data can be found at: https://physionet.org/content/mimiciv/3.1/; https://physionet.org/content/eicu-crd-demo/2.0.1/.

Reproduced under the paper's license (CC BY), from the paper cited above.

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Version 1, 30 September 2026: the first record

Recorded: type, language, journal, volume, pages, dates, 4 authors, 5 keywords, 3 funders, 33 references.

Cite

This paper

Xiang, H., Chen, X., Wang, L., & Lai, W. (2026). Early prophylactic heparin use is associated with reduced mortality in patients with non-traumatic subarachnoid hemorrhage. Frontiers in neurology, 17, 1753639. https://doi.org/10.3389/fneur.2026.1753639

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