Hospital frailty risk score and outcomes of chronic mesenteric ischemia revascularization: Nationwide Inpatient Sample 2005–2020 analysis

Chronic mesenteric ischemia (CMI) typically affects older adults, and often requiring revascularization. Frailty, a state of decreased physiological reserve, may impact the outcomes of CMI treatment. The purpose of was to determine the impact of frailty, assessed by the Hospital Frailty Risk Score, on in-hospital outcomes after CMI revascularization. Data from the Nationwide Inpatient Sample 2005-2020, were analyzed in this retrospective study. Inclusion criteria were adults ≥20 years old who underwent revascularization for CMI. Patients were categorizing patients into low-, intermediate-, and high-frailty risk groups. Logistic regression analyses, adjusted for confounders, was used to assess associations between frailty risk and outcomes. The study included 4100 patients with a mean age of 71.2 years, of whom 71% were female. Patients in the intermediate and high frailty risk groups had significantly increased odds of in-hospital mortality (intermediate risk: adjusted odds ratio [aOR] = 3.33, 95% confidence interval [CI]: 2.07-5.35; high risk: aOR = 3.68, 95% CI: 2.15-6.31), unfavorable discharge (intermediate risk: aOR = 2.25, 95% CI: 1.83-2.77; high risk: aOR = 3.77, 95% CI: 2.91-4.88), prolonged hospital stay (intermediate risk: aOR = 2.40; high risk: aOR = 4.85), transfusions (intermediate risk: aOR = 1.97; high risk: aOR = 4.58), and overall complications (intermediate risk: aOR = 3.84; high risk: aOR = 8.74) compared to low-risk patients. Frailty is associated with worse outcomes of patients with CMI undergoing revascularization. Thus, it is important to incorporate frailty assessment in preoperative risk stratification and management of CMI revascularization.