Causal graph fusion across incomplete cohorts and causal steering of tabular foundation models

Clinical data are split across incomplete cohorts with partially overlapping variables. Causal discovery under missing data and multi-source integration have developed separately, and tabular foundation models cannot take a causal graph without retraining. We make two contributions. First, causal graph fusion learns a partial ancestral graph on the shared variables, fuses it into each cohort's graph under temporal background knowledge and lets Markov blankets guide re-imputation, so missing data are handled inside discovery. Second, causal attention steering compiles the learned graph into the attention of a frozen tabular foundation model at inference. Against known ground truth, fusion dominates pooled and per-cohort baselines in every missingness and heterogeneity condition tested (p<0.001), and steering improves discrimination under distribution shift (p<10^{-5}), a gain that a random graph does not produce. In two spinal cord injury cohorts, fusion orients age, albumin and hemoglobin as ancestors of length of stay, a set no single cohort orients in full, and yields compact, temporally ordered predictor sets that match or exceed automatic feature selection on four of five outcomes.