Francisco Javier Garcia-Sanchez

@ucm.es

Associated Professor of Medicine Department at Faculty of Medicine
Universidad Complutense Of Madrid

Francisco Javier Garcia-Sanchez


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https://researchid.co/papuca69

RESEARCH, TEACHING, or OTHER INTERESTS

Internal Medicine, Surgery
23

Scopus Publications

Scopus Publications

  • Early Mobilization Compliance as a Quality Indicator After Hip Fracture Surgery: An Observational Study
    Nelly Esperanza Endara-Tello, Miriam Batalla-Pascua, Silvia Córdoba-Ortega, Miriam Álvarez-Villarreal, Francisco Javier García-Sánchez
    Journal of Clinical Medicine, 2026
    Background: Hip fracture represents a major public health challenge in aging populations and is associated with high morbidity, functional decline, and increased healthcare utilization. Early mobilization within the first 24 h after surgery is considered a key quality indicator in hip fracture care and has been associated with improved functional recovery and reduced postoperative complications. The aim of this study was to evaluate compliance with early mobilization and identify clinical and organizational factors associated with its implementation. Methods: A retrospective observational study was conducted in the surgical hospitalization unit of a tertiary hospital in Madrid, Spain. All adult patients who underwent hip fracture surgery between January and December 2023 were included. Sociodemographic, clinical, and functional variables were collected from electronic medical records. Early mobilization within the first 24 h after surgery was defined as the primary outcome and analyzed in relation to clinical and organizational variables. Results: A total of 139 patients were included, with a mean age of 82.4 ± 11.3 years, and 79.1% were women. Early mobilization was achieved in 66.2% of patients. Significant associations were observed between early mobilization and blood transfusion requirements (p = 0.002), postoperative radiography performed within the first 24 h (p = 0.004), and the presence of an explicit medical order for mobilization (p < 0.001). No significant associations were identified with age, sex, functional dependency, cognitive impairment, baseline mobility, or ASA classification. Conclusions: Early mobilization after hip fracture surgery was associated with several modifiable clinical and organizational factors in this cohort. However, these findings should be interpreted with caution because fracture-specific and surgery-specific variables were not available. Implementing standardized protocols, automatic mobilization orders, and optimized perioperative management strategies may improve compliance with this key quality indicator and enhance postoperative recovery.
  • Hypernatremia in Hospital-at-Home Patients: Prevalence, Clinical Profile, and Mortality in Institutionalized and Home-Dwelling Older Adults
    María de Castro-García, Sara Núñez-Palomares, Juan Miguel Antón-Santos, Alejandro Estrada-Santiago, Yolanda Majo-Carbajo, et al.
    Medical Sciences Basel Switzerland, 2026
    Background: Hypernatremia is an infrequent but clinically relevant electrolyte disorder in older adults and is associated with poor outcomes. Patients managed through Hospital-at-Home (HaH) programs, particularly those living in institutional settings, are especially vulnerable due to functional dependency and cognitive impairment. Evidence regarding the prevalence and prognostic impact of hypernatremia in HaH settings remains limited. Methods: We conducted a retrospective observational cohort study including all patients admitted to a Hospital-at-Home unit between 2019 and 2024. Patients were classified according to care setting as home-dwelling or institutionalized. Hypernatremia was defined as a serum sodium concentration &gt;145 mmol/L. Sociodemographic, functional (Barthel Index), and cognitive (Global Deterioration Scale) variables were collected. Mortality during HaH admission and at 30, 60, and 90 days was analyzed, and survival was assessed using Kaplan–Meier methods. Results: A total of 4501 patients were included, of whom 2701 were treated at home and 1800 in institutional settings. Hypernatremia was significantly more prevalent among institutionalized patients than among home-dwelling patients (3.1% vs. 0.8%, p &lt; 0.001). Institutionalized patients with hypernatremia showed greater functional dependency (Barthel Index 11 vs. 15, p = 0.041) and more advanced cognitive impairment (GDS 6 vs. 5.5, p = 0.033) compared with those without hypernatremia. Mortality among institutionalized patients with hypernatremia was high, reaching 32.9% during HaH admission, 61.2% at 30 days, 70.6% at 60 days, and approximately 79% at 90 days. Kaplan–Meier analysis demonstrated a rapid decline in survival during the first month following diagnosis. Conclusions: In Hospital-at-Home programs, hypernatremia is more prevalent among institutionalized older adults and is strongly associated with severe functional and cognitive impairment and very high short- and medium-term mortality. These findings suggest that hypernatremia should be considered a marker of advanced frailty rather than an isolated electrolyte disturbance.
  • Physical Restraint Use in Acute Care Hospitals: A Diagnostic Study on Knowledge, Documentation, and Patient Safety from a Humanization Perspective
    Alicia Albalat-Rodríguez, Ana Fernández-García, Violeta Hernández-De Arribas, Nuria Pérez-Panizo, Patricia Nieto-Alcantud, et al.
    Healthcare Switzerland, 2026
    Background: The use of physical restraints in hospital settings remains a controversial practice due to its ethical, legal, and safety implications. Although restraints are intended to prevent falls or manage agitation, their inappropriate use may compromise patient dignity, autonomy, and quality of care. Current healthcare policies emphasize restraint reduction, appropriate documentation, and professional training as key elements of humanized and safe care. Methods: A descriptive cross-sectional study based on an anonymous self-administered survey was conducted in a tertiary university hospital as the diagnostic phase of a quality improvement project aimed at evaluating healthcare professionals’ knowledge, perceptions, and documentation practices related to physical restraint use. A structured ad hoc questionnaire was distributed to registered nurses and nursing assistants working in adult inpatient units using a non-probabilistic convenience sampling strategy. The survey explored training, clinical decision-making, communication with patients and families, awareness of institutional protocols, and use of the electronic health record (EHR). Descriptive analyses and Pearson’s chi-square tests were performed using IBM SPSS Statistics. Results: A total of 241 professionals participated. More than half of respondents (54.8%) reported no formal training in physical restraint use, and only 27.4% considered their training sufficient. Although 86.3% stated they were familiar with restraint indications, only 53.5% were aware of the existence of a structured EHR restraint registry, and just 31.0% consistently completed it. Documentation of restraint removal was particularly low (32.9%). Furthermore, significant discrepancies were observed between regulatory definitions of restraints and professionals’ perceptions regarding practices requiring formal documentation. Statistically significant associations were identified between professional category, perceived training adequacy, and knowledge of physical restraint indications. Conclusions: This diagnostic phase identified substantial gaps between regulatory requirements, professional knowledge, and real-world documentation practices related to physical restraint use. The findings highlight the need for competency-based training strategies, standardized documentation processes, and strengthened institutional leadership to promote patient safety, regulatory compliance, and the humanization of hospital care.
  • Development and Validation of the Intimate Partner Violence Nursing Competency Scale (IPVNCS): A Psychometric Tool to Strengthen Clinical Detection and Intervention
    David Casero-Benavente, Natalia Mudarra-García, Guillermo Charneco-Salguero, Leonor Cortes García-Rodríguez, Francisco Javier García-Sánchez, et al.
    Journal of Clinical Medicine, 2026
    Background: Intimate partner violence (IPV) represents a major public health problem in Europe, with significant physical, psychological, and social consequences. Nurses are often the first professionals capable of detecting early signs of IPV, yet they lack validated instruments to assess their clinical competency in detection, evaluation, documentation, and intervention. This study aimed to develop and validate the Intimate Partner Violence Nursing Competency Scale (IPVNCS), aligned with the Nursing Intervention Classification (NIC 6403). Methods: A cross-sectional psychometric study was conducted among registered nurses in the Community of Madrid. A 30-item Likert-type self-administered instrument (1–5 scale) was developed based on NANDA, NIC 6403, and NOC frameworks. A total of 202 nurses participated. Reliability was assessed through Cronbach’s alpha. Construct validity was examined using exploratory factor analysis (EFA) with Promax rotation and confirmatory factor analysis (CFA) using AMOS 26. Ethical approval was obtained (CEU San Pablo, code 843/24/104). Results: After item refinement, 26 items remained across four dimensions: (1) Intervention and Referral, (2) Detection and Assessment, (3) Documentation and Recording-keeping, (4) Psychosocial Support. The instrument showed excellent reliability (α = 0.97). KMO was 0.947 and Bartlett’s test was significant (p &lt; 0.001). CFA demonstrated satisfactory fit: χ2/df = 2.066, RMSEA = 0.073, CFI = 0.92, TLI = 0.91, NFI = 0.86. The final model adequately represented the latent structure. After debugging, its psychometric properties were significantly improved. Four redundant items were eliminated, achieving internal consistency (α = 0.97), a KMO value of 0.947 and a significant Bartlett’s test of sphericity. It showed a better fit, according to χ2/df = (2.066); Parsimony = (720.736); RMR (0.0529; RMSEA (0.073); NFI (0.860); TLI (0.910) and CFI (0.920). The final model provides an adequate representation of the latent structure of the data. This study provides initial evidence of construct validity and internal consistency reliability of the IPVNCS. Conclusions: The IPVNCS is a valid and reliable tool to assess nursing competencies for clinical management of IPV. It supports structured evaluation across four core nursing domains, enabling improved educational planning, clinical decision-making, and quality of care for victims. The scale fills a gap in clinical nursing assessment tools and can support protocol development in emergency, primary care, and hospital settings.
  • Perceived competence and cognitive bias in nurses' assessment of intimate partner violence: a cross-sectional study
    David Casero-Benavente, Natalia Mudarra-García, Guillermo Charneco-Salguero, Francisco Lencina-Navarro, Diego Pérez-Iglesias, et al.
    Frontiers in Public Health, 2026
    Introduction Intimate partner violence (IPV) represents a complex social and health problem that requires multidisciplinary responses. Healthcare professionals, particularly nurses, play a key role in the identification and management of IPV cases. However, limited training and potential cognitive biases may affect professional assessment and intervention. Methods A cross-sectional descriptive study was conducted among 202 nursing professionals in Spain. Perceived competence in IPV management was evaluated using the validated Intimate Partner Violence Competency Scale for Nurses (ECVPE), which assesses four dimensions: intervention and referral, detection and assessment of abuse, documentation and record-keeping, and psychosocial support. Descriptive statistics, Student's t -tests, and one-way ANOVA were used to analyze differences according to sociodemographic variables. Results The lowest levels of perceived competence were observed in the intervention and referral dimension (M = 2.45), while the highest scores were found in psychosocial support (M = 3.36). Professional experience was the only variable significantly associated with perceived competence in the dimensions of detection and documentation of abuse. Additionally, most participants conceptualized IPV primarily as violence against women in heterosexual relationships, indicating the presence of perceptual biases that may influence professional assessment. Conclusions Nursing professionals reported heterogeneous levels of perceived competence in IPV management, with notable gaps in intervention and referral processes. The results highlight the need for training strategies that strengthen professional competencies while addressing implicit biases in the interpretation of violence within intimate relationships.
  • From Emergency Department to Operating Room: The Role of Early Prehabilitation and Perioperative Care in Emergency Laparotomy: A Scoping Review and Practical Proposal
    Francisco Javier García-Sánchez, Fernando Roque-Rojas, Natalia Mudarra-García
    Journal of Clinical Medicine, 2025
    Background: Emergency laparotomy (EL) carries high morbidity and mortality relative to elective abdominal surgery. While Enhanced Recovery After Surgery (ERAS) principles improve outcomes in elective care, their translation to emergencies is inconsistent. The emergency department (ED) provides a window for rapid risk stratification and pre-optimization, provided that interventions do not delay definitive surgery. Methods: We conducted a PRISMA-ScR–conformant scoping review to map ED-initiated, ERAS-aligned strategies for EL. PubMed, Scopus, and Cochrane were searched in February 2025. Eligible sources comprised ERAS guidelines, systematic reviews, cohort studies, consensus statements, and programmatic reports. Evidence was charted across five a priori domains: (i) ERAS standards, (ii) comparative effectiveness, (iii) ED-feasible pre-optimization, (iv) risk stratification (Emergency Surgery Score [ESS], frailty, sarcopenia), and (v) oncological emergencies. Results: Thirty-four sources met inclusion. ERAS guidelines codify rapid assessment, multimodal intraoperative care, and early postoperative rehabilitation under a strict no-delay rule. Meta-analysis and cohort data suggest ERAS-aligned pathways reduce complications and length of stay, though heterogeneity persists. ED-feasible measures include multimodal analgesia, goal-directed fluids, early safe nutrition, respiratory preparation, and anemia/micronutrient optimization (IV iron, vitamin B12, folate, vitamin D). Sarcopenia, frailty, and ESS consistently predicted adverse outcomes, supporting targeted bundle activation. Evidence from oncological emergencies indicates feasibility under no-delay governance. Conclusions: A minimal, ED-initiated, ERAS-aligned bundle is feasible, guideline-concordant, and may shorten hospitalization and reduce complications in EL. We propose a practical framework that links rapid risk stratification, opportunistic pre-optimization, and explicit continuity into intra- and postoperative care; future studies should test fidelity, costs, and outcome impact in pragmatic emergency pathways.
  • Use of Benzodiazepines in Medical Students: A Comparative Analysis Between Medical and Other University Degrees
    Paula Fernández de Frutos, Francisco Javier García-Sánchez, Natalia Mudarra-García, Fernando Roque-Rojas, Syed Ihtisham-Kakakhel, et al.
    Medical Sciences, 2025
    Background: The use of benzodiazepines among university students has been scarcely investigated. This situation raises particular concerns in medical students, due to their exposure to stressful situations and, especially, their familiarity with psychotropic drugs. Material and methods: A descriptive cross-sectional observational study was conducted using an anonymous online survey disseminated among universities in the Community of Madrid during April 2024. Results: 25.07% of students stated they had used benzodiazepines at least once, especially from the third academic year onwards. The prevalence was higher among medical students (32.34%). Use was mainly occasional, although 20.21% reported daily use. Among the reasons for use, managing academic stress reached 45.74%. Up to 15.96% of respondents reported a feeling of dependence, and 32.26% noticed concentration difficulties as a side effect of benzodiazepine use. Conclusions: Benzodiazepine use is a relevant phenomenon among university students, with particular incidence in medical degrees. Its onset usually coincides with advanced stages of the degree, which underscores the need for preventive interventions tailored to the academic environment and for the rational use of psychotropic drugs in young populations.
  • Assessment of Sarcopenia Using Rectus Femoris Ultrasound in Emergency Patients—A Cross-Sectional Study
    Francisco Javier García-Sánchez, Victoria Emilia Souviron-Dixon, Fernando Roque-Rojas, Natalia Mudarra-García
    Journal of Clinical Medicine, 2025
    Background: Sarcopenia is a progressive muscle disorder commonly associated with aging and chronic diseases. It has been linked to worse clinical outcomes and increased vulnerability during acute illness. However, its prevalence in emergency department (ED) populations remains underexplored. This study aimed to evaluate the presence of sarcopenia among ED patients using ultrasound, determine its relationship with underlying comorbidities, and assess its association with in-hospital complications. Methods: We conducted a prospective, observational, cross-sectional study at the Infanta Cristina University Hospital (Madrid, Spain) from January to May 2024. A total of 150 patients aged 18 years and older who presented to the ED were assessed for sarcopenia using rectus femoris ultrasound. Sociodemographic, clinical, and laboratory variables were collected. A multivariate logistic regression model was used to identify independent predictors of in-hospital complications. Patients were followed for 30 days to evaluate outcomes. Comparisons were made between diagnostic groups and sarcopenia indices. Results: The mean age of the cohort was 70.7 years (SD 18.15), and 52% were male. Neurological diseases were associated with the highest degree of sarcopenia (mean Y-axis: 0.93 cm), followed by digestive (1.05 cm), hematological (1.05 cm), and cardiovascular diseases (1.08 cm). Patients who developed in-hospital complications had lower mean muscle thickness values compared to those without complications (1.08 cm vs. 1.24 cm; p &lt; 0.05). Sarcopenia was significantly correlated with the presence of comorbidities and poor clinical outcomes. Conclusions: These findings support the integration of sarcopenia screening protocols into emergency care and highlight the need for studies exploring early nutritional or rehabilitation interventions targeted at high-risk patients.
  • Impact of Exams on Diet, Physical Activity, and Body Composition in University Students
    Natalia Mudarra-García, Marina Pérez-Mudarra, Ismael Ortuño-Soriano, Raquel Badía-Iborra, María Jesús Vicente-Galán, et al.
    Nutrients, 2025
    Background: Bad dietary habits and sedentary lifestyles alter body composition, increasing disease risk. Methods: We conducted a prospective, comparative, longitudinal observational study among nursing students from Complutense University of Madrid. Data were collected in two periods: before exams (January 2024) and during exams (May 2024). Body composition was assessed via bioimpedance (Beurer BF 1000), dietary habits through the modified Kidmed survey, and physical activity using the IPAQ. Results: During exam preparation, fat mass significantly increased (25.43% to 28.79%, p = 0.016), muscle mass significantly decreased (39.70% to 36.20%, p &lt; 0.001), and visceral fat rose notably (2.34 to 3.52, p &lt; 0.001). Students exhibiting poor dietary quality increased (54.2% to 80.0%, p &lt; 0.001), vigorous physical activity dramatically decreased (84.7% to 11.1%, p &lt; 0.001), and sedentary time increased significantly (408.24 to 543.61 min/day, p &lt; 0.001). Conclusions: Our findings suggest dietary deterioration and reduced physical activity during exams adversely affect students’ body composition.
  • Feasibility of a Pre-Operative Morphofunctional Assessment and the Effect of an Intervention Program with Oral Nutritional Supplements and Physical Exercise
    Natalia Mudarra-García, Fernando Roque-Rojas, Almudena Nieto-Ramos, Visitación Izquierdo-Izquierdo, Francisco Javier García-Sánchez
    Nutrients, 2025
    Background: Surgical patients often experience nutritional imbalances due to their underlying condition and the forthcoming surgical procedure. These imbalances can increase the risk of post-operative complications. To mitigate such risks, a comprehensive nutritional assessment—also known as morphofunctional assessment—should be conducted. This includes evaluating body composition (muscle and fat mass), muscle strength, and functional capacity. Methods: We conducted an observational, prospective, pre-post interventional study involving 138 patients undergoing major elective surgery. Each patient received a morphofunctional assessment and an individualized prehabilitation program, including nutritional supplementation, physical exercise, and comorbidity optimization for 21 days before surgery and one month afterward. Outcomes were assessed through bioimpedance (muscle mass), muscle ultrasound (QRF thickness), dynamometry (strength), and visceral fat ultrasound (fat reduction). Results: The patient’s morphofunctional assessment and subsequent nutritional and physical exercise optimization performed during the month before surgery in the prehabilitation consultation led to an increase in muscle mass (measured by bioimpedance analysis, p = 0.001), and muscle ultrasound, (QRF thickness: p &lt; 0.001) and dinamometry (muscle strength: p = 0.014); a reduction in preperitoneal visceral fat thickness (reduction p &lt; 0.001); and an improvement in the patients’ nutritional status, with a decrease in malnutrition rates (64.8% vs. 31.8%). As a result, post-operative complications were effectively prevented (p &lt; 0.001). Conclusions: Pre-operative patient optimization by means of a prehabilitation program led to increased muscle strength, improved muscle mass, reduced complication rates, and shorter hospital stays. In addition, patients maintained their quality of life and functional capacity following surgery.
  • Prehabilitation in Major Surgery: An Evaluation of Cost Savings in a Tertiary Hospital
    Natalia Mudarra-García, Fernando Roque-Rojas, Visitación Izquierdo-Izquierdo, Francisco Javier García-Sánchez
    Journal of Clinical Medicine, 2025
  • Application of Artificial Intelligence as an Aid for the Correction of the Objective Structured Clinical Examination (OSCE)
    Davide Luordo, Marta Torres Arrese, Cristina Tristán Calvo, Kirti Dayal Shani Shani, Luis Miguel Rodríguez Cruz, et al.
    Applied Sciences Switzerland, 2025
  • Mortality reduction in older COVID-19-patients hospitalized in Spain during the second pandemic wave from the SEMI-COVID-19 Registry
    José-Manuel Casas-Rojo, Juan-Miguel Antón-Santos, Jesús Millán-Núñez-Cortés, Ricardo Gómez-Huelgas, José-Manuel Ramos-Rincón, et al.
    Scientific Reports, 2023
  • Differences in surgical results for patients with pre-operative anemia treated with or without iron before surgery
    Francisco Javier García Sánchez, Almudena Nieto Ramos, Natalia Mudarra García
    Metas De Enfermeria, 2023
  • The Advanced Practice Nurse in a Surgical Prehabilitation Program
    Natalia Mudarra García, Francisco Javier García Sánchez
    Metas De Enfermeria, 2023
  • Actinomycosis: two gynaecological clinical cases. It's not just IUDs to blame!
    A. de Labaig, M. Guzmán Muñoz, F.J. García Sánchez, J.M. Menéndez Fuster
    Clinica E Investigacion En Ginecologia Y Obstetricia, 2022
  • Does admission acetylsalicylic acid uptake in hospitalized COVID-19 patients have a protective role? Data from the Spanish SEMI-COVID-19 Registry
    Francesc Formiga, Manuel Rubio-Rivas, José María Mora-Luján, Samara Campos Escudero, Rosa Fernandez Madera Martinez, et al.
    Internal and Emergency Medicine, 2022
  • Evolution of the use of corticosteroids for the treatment of hospitalised COVID-19 patients in Spain between March and November 2020: SEMI-COVID national registry
    David Balaz, Philip Erick Wikman-Jorgensen, Vicente Giner Galvañ, Manuel Rubio-Rivas, Borja de Miguel Campo, et al.
    Journal of Clinical Medicine, 2021
  • Positioning document on incorporating point-of-care ultrasound in Internal Medicine departments
    J. Torres Macho, F.J. García Sánchez, P. Garmilla Ezquerra, L. Beltrán Romero, J. Canora Lebrato, et al.
    Revista Clinica Espanola, 2018
  • Teaching the basics of echocardiography in the undergraduate: Students as mentors
    A. Arias Felipe, J. Doménech García, I. Sánchez los Arcos, D. Luordo, F.J. García Sánchez, et al.
    Revista Clinica Espanola, 2017
  • Basic abdominal point-of-care ultrasound training in the undergraduate: Students as mentors
    Gonzalo Garcia-Casasola, Francisco Javier García Sánchez, Davide Luordo, Deborah Forrester Zapata, María Carnevali Frías, et al.
    Journal of Ultrasound in Medicine, 2016
  • Secondary hyperparathyroidism prevalence and profile, between diabetic and non-diabetic patients with stage 3 to 4 chronic kidney disease attended in internal medicine wards. MiPTH study
    José Carlos Arévalo-Lorido, Juana Carretero-Gómez, Francisco García-Sánchez, Enrique Maciá-Botejara, José Manuel Ramiro-Lozano, et al.
    Diabetes and Metabolic Syndrome Clinical Research and Reviews, 2016
  • Prevalence of secondary hyperparathyroidism in patients with stage 3 and 4 chronic kidney disease seen in internal medicine
    Juan Carlos Bureo, Jose Carlos Arévalo, Joaquín Antón, Gaspar Adrados, Jose Luis Jiménez Morales, et al.
    Endocrinologia Y Nutricion, 2015