Association between enoxaparin administration and ICU 28-day mortality in sepsis patients: A comparative study

Limited data are available on enoxaparin use in sepsis patients requiring mechanical ventilation (MV) with platelet counts ≥150 × 10⁹/L, and its survival benefit remains unclear. This study aimed to investigate the association between enoxaparin administration and intensive care unit (ICU) 28-day mortality.

This was a retrospective multicenter cohort study that utilized data from the eICU Collaborative Research Database. The relationship between enoxaparin administration and ICU 28-day mortality was primarily investigated using a multivariable Cox regression model with inverse probability weighting (IPTW) based on the propensity score.

A total of 2078 sepsis patients requiring MV with platelet counts ≥150 × 10⁹/L were included in the study. The median age of the cohort was 66 years (interquartile range, 54-76 years). Enoxaparin was administered to 483 patients (23.2 %), while 1595 patients (76.8 %) did not receive enoxaparin. Of the 483 patients who received enoxaparin, 374 patients (18.0 % of the total cohort) were administered it on the first day of ICU admission. The ICU 28-day mortality was 7.2 % (35/483) in the enoxaparin group compared to 13.9 % (222/1595) in the non-enoxaparin group. In the IPTW analysis, there was a significant association between enoxaparin administration and ICU 28-day mortality [hazard ratio (HR), 0.6; 95 % confidence interval (CI), 0.4-0.9; p = 0.010].

Enoxaparin administration was associated with a lower risk of ICU 28-day mortality among sepsis patients requiring MV with platelet counts ≥150 × 10⁹/L. Given the observational nature of the study, further research is needed to confirm these findings.