Disseminated Intravascular Coagulation (
DIC) commonly complicates
sepsis and considerably worsens mortality. Recent studies suggested that
anticoagulant therapies improved mortality only in specific
sepsis populations, and key pathologies for selecting optimal targets needed to be identified.
Anticoagulant activities were naturally altered with aging. This study aimed to evaluate age-related differences in efficacy of
anticoagulant therapies in
sepsis. This post hoc analysis of a nationwide multicenter cohort study was conducted in 42 intensive care units in Japan. Adult patients with septic
DIC were divided into
anticoagulant and control groups. Age-related changes in predicted mortality in both groups were compared using a logistic regression model including 2-way interaction terms. Patients were also stratified into 3 subsets based on age, and propensity score-adjusted Cox regression analyses were conducted to examine survival effect of
anticoagulants in each subset. We included 1432 patients with septic
DIC; 867 patients received
anticoagulants and 565 received none. Age-related change in predicted mortality was significantly different between groups (P for interaction = 0.013), and the gap between groups was broad in the younger population. Similarly, in Cox regression analyses,
anticoagulant therapies were associated with significantly lower mortality in the subsets of age ≤ 60 and 60-79 (hazard ratios = 0.461, 0.617, P = 0.007, 0.005, respectively), whereas there was no difference in survival between the groups in the subsets of age ≥ 80. The efficacy of
anticoagulant therapies for septic
DIC might be associated with patient age.