DOI: 10.1111/aas.70303 ISSN: 0001-5172

Coagulopathy in Critically Ill Patients With Sepsis: Protocol for a Scoping Review

Christian H. S. Andersen, Josefine Dupont Hansen, Christine Lodberg Hvas, Kirsten Møller, Kim Oren Gradel, Ann Merete Møller, Lene Russell
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ABSTRACT

Background

Coagulopathy is a common complication in patients with sepsis, ranging from subclinical coagulation activation only seen in laboratory values to disseminated intravascular coagulation ( DIC ). Over the past 25 years, several scoring systems have been developed to diagnose coagulopathy and DIC in critically ill patients. However, the presence of multiple overlapping definitions, diagnostic criteria and numerous scoring systems adds complexity and poses challenges for clinical decision‐making.

Objectives

This scoping review aims to systematically map how coagulopathy and DIC in adult patients with sepsis are defined, diagnosed and managed, and to summarise risk factors and reported clinical outcomes. Knowledge gaps will be identified to inform future research and clinical practice.

Eligibility Criteria

Eligible studies will include original clinical research of any design published from 1 January 1996 onwards reporting on coagulopathy or DIC in adult patients (≥ 18 years) with sepsis. Non‐original articles (reviews, opinion pieces, editorials, guidelines, case reports, consensus statements) and conference abstracts will be excluded. We will only include studies published in English.

Sources of Evidence

Searches will be conducted in PubMed, EMBASE, Web of Science and CENTRAL, and supplemented by reference list screening.

Charting Methods

Two reviewers will independently screen abstracts and full texts, and extract data in duplicate using a piloted extraction form. In case of disagreement, a third senior reviewer will adjudicate and make the final decision on study inclusion. Extracted information will include study characteristics, population details, diagnostic approaches, frequency of coagulopathy, management strategies and clinical outcomes, as well as contextual factors such as hospital settings and geographical origin. Results will be presented using descriptive statistics, tables and narrative summaries. A critical appraisal of the quality of the included studies will be conducted.

Conclusions

This scoping review will provide a comprehensive overview of definitions, diagnostic methods, management patterns and reported outcomes of coagulopathy and DIC in adult patients with sepsis. The findings will clarify the current practice variation, highlight knowledge gaps and areas of uncertainty, and guide priorities for future research and clinical decision‐making.

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