Application status of anticoagulant strategies for sepsis patients among the physicians: a multicenter cross-sectional questionnaire-based study

Objective To survey the current status of anticoagulant therapy for sepsis among the physicians in China.

Methods This was a web-based, multicenter, cross-sectional questionnaire study, conducted over two months (July to September 2022). The questions were designed by sepsis workshop members in EICU of Zhongshan Hospital. The questionnaires were sent to and then collected from physicians who were involved in the care of ICU patients with sepsis nationwide from July to September in 2022.

Results The questionnaire results were collected and analyzed from 157 physicians from 157 centers. About half the ICUs only conducted classical coagulation laboratory tests. For the sepsis patients, The most physicians (72.6%-80.9%) preferred to choose the low molecular weight heparin (LMWH). When heparin-induced thrombocytopenia (HIT) Ⅱ occurred or had HIT Ⅱ past, most physicians (45.2%-61.1%) didn't choose to give non-heparin anticoagulants. For postoperative patients taking warfarin or direct oral anticoagulant (DOAC) preoperatively, most physicians (30.6%-45.2%) didn't choose anticoagulation or gave LMWH.

Conclusions Most physicians prefer anticoagulation treatment in patients with sepsis and LMWH is most widely used. For HIT, most physicians do not choose the strategy recommended by guidelines; for perioperative patients taking oral anticoagulants, more physicians hold a cautious attitude towards anticoagulation therapy.