Occurrence of Femoral Nerve Injury among Patients Undergoing Transfemoral Percutaneous Catheterization Procedures in the United States.

BACKGROUND

The proximity of the femoral nerve to the femoral artery renders it vulnerable to injury during transfemoral percutaneous catheterization (TPC) procedures.

OBJECTIVE

To determine the incidence of femoral nerve injury in patients undergoing cardiac catheterization in a nationally representative inpatient database.

METHODS

We analyzed data released annually from the Nationwide Inpatient Sample. We pooled data from 2002 to 2010 and, using the ICD-9-CM procedure codes, identified patients who underwent TPC. We subsequently identified occurrences of femoral nerve injury in this cohort. Baseline characteristics, comorbid conditions, in-hospital complications, and discharge outcomes-including mortality, mild disability, and moderate-to-severe disability-were compared between patients with femoral neuralgia and those without.

RESULTS

Of the 15,894,201 patients who underwent percutaneous catheterization procedures, 597 (3.8 per 100,000 procedures) developed femoral nerve injury. The incidence of femoral nerve injury was higher in women: 57% versus 39%, < 0.004. Patients with coexisting congestive heart failure or coagulopathy had a non-significant increase in the incidence of femoral nerve injury. There was no in-hospital mortality among patients who developed femoral nerve injury, but the rate of discharge to nursing facilities was higher in this cohort: 17% versus 6%, < 0.001. After adjusting for age, gender, presence of congestive heart failure, and coagulopathy, femoral nerve injury during percutaneous catheterization procedures was independently associated with moderate-to-severe disability at discharge (odds ratio 2.3; 95% confidence interval 1.4-3.8; < 0.001).

CONCLUSION

Femoral nerve injury is a rare complication of percutaneous catheterization procedures that may increase the likelihood of moderate-to-severe disability at patient's discharge.