Can Heparin Improve Clinical Outcomes in Cardiac Arrest? A Retrospective Cohort Study from the EICU Collaborative Research Database

Abstract Background: Studies indicate that heparin can improve survival in patients with out-of-hospital cardiac arrest. Thus, we aimed to investigate the effect of heparin on hospitalized patients with cardiac arrest. Methods: Clinical data of cardiac arrest patients from the eICU Collaborative Research Database V2.0 were retrospectively analyzed. We compared neurological prognosis and primary outcomes in a heparin group that received unfractionated heparin or low molecular weight heparin with a non-heparin group. Additionally, we compared the two heparin sub-groups. Results: After propensity score matching, there were 673 patients in the heparin group and 1346 patients in the non-heparin group. The Glasgow Coma Scale score was significantly better in the heparin group (P<0.05). There were no significant differences in terms of spontaneous respiratory function recovery, dementia, or vegetative state between the two groups (P>0.05). Intensive care unit (ICU) mortality and hospital mortality rates were significantly lower in the heparin group (P<0.05). The duration of mechanical ventilation, length of stay in ICU, and length of stay in hospital were significantly longer in the heparin group (P<0.05). Median survival time was significantly longer in the heparin group (P<0.001). In the comparison of patients who received unfractionated heparin and low molecular weight heparin (267 in each group), there were no significant differences in Glasgow Coma Scale score, ICU mortality, hospital mortality, or median survival time between the two groups (P>0.05). Conclusions: Heparin administration may be beneficial in reducing the mortality rate and prolonging the survival time of in-hospital patients with cardiac arrest. It may also improve the prognosis of neurological function to a certain extent. Outcomes were not significantly different between patients who received unfractionated heparin and those who received low molecular weight heparin.