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

Abstract

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%, p < 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%, p < 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; p < 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.