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.