Patients with a limited life expectancy have an increased risk of thromboembolic and bleeding complications. Anticoagulants are often continued until death, independent of their original indication. We aimed to identify the opinions of physicians about the use of anticoagulants at the end of life. A mixed-method research design was used. A secondary analysis was performed on data from a vignette study and an interview study. Participants included general practitioners and clinical specialists. Physicians varied in their opinions: some would continue and others would stop anticoagulants at the end of life because of the risk of thromboembolic or bleeding complications. The improvement or preservation of patients' quality of life was a reason for both stopping and continuing anticoagulants. Other factors considered in the decision-making were the types of anticoagulant, the indication for which the anticoagulant was prescribed, underlying diseases, and the condition and life expectancy of the patient. Factors that made decision-making difficult were the lack of evidence on either strategy, uncertainty about patients' life expectancy, and the fear of harming patients. Which decision was eventually made seems largely dependent on the choice of the patient. In conclusion, there is a substantial variation in physicians' opinions regarding the use of anticoagulants in patients with a limited life expectancy. Physicians agree that the primary goal of medical care at end of life is the improvement or preservation of patients' quality of life. An important barrier to decision-making is the lack of evidence about the risks and benefits of stopping anticoagulants.

预期寿命有限的患者发生血栓栓塞和出血并发症的风险增加。抗凝剂通常持续使用至死亡，与其最初的适应症无关。我们旨在确定医生对临终时使用抗凝剂的看法。使用了混合方法研究设计。对来自小插曲研究和访谈研究的数据进行了二次分析。参与者包括全科医生和临床专家。医生意见不一：有些人会继续使用抗凝剂，有些人会在生命末期停用抗凝剂，因为存在血栓栓塞或出血并发症的风险。患者生活质量的改善或保持是停用和继续使用抗凝剂的一个原因。决策中考虑的其他因素包括抗凝剂的类型、抗凝剂的适应症、基础疾病以及患者的状况和预期寿命。使决策变得困难的因素是缺乏关于这两种策略的证据、患者预期寿命的不确定性以及对伤害患者的恐惧。最终做出哪个决定似乎很大程度上取决于患者的选择。总之，医生对预期寿命有限的患者使用抗凝剂的看法存在很大差异。医生一致认为，临终医疗的主要目标是改善或保持患者的生活质量。