In-Hospital Outcomes and Mortality After Revascularization for Chronic Mesenteric Ischemia by Maintenance Dialysis Status: A National Inpatient Sample Analysis, 2006–2020

INTRODUCTION: Evidence on in-hospital outcomes after chronic mesenteric ischemia (CMI) revascularization in patients receiving maintenance dialysis is limited. METHODS: We analyzed adult CMI-coded hospitalizations undergoing endovascular or open revascularization in the 2006-2020 National Inpatient Sample. Hospitalizations with and without maintenance dialysis were compared using 1:2 propensity score matching and survey-weighted multivariable regression. RESULTS: Of 7,962 eligible hospitalizations, 411 (5.2% of the unweighted sample) involved maintenance dialysis. Maintenance dialysis was associated with higher adjusted odds of in-hospital mortality (aOR 1.96), non-routine discharge (aOR 1.46), prolonged hospitalization (aOR 1.41), transfusion (aOR 1.43), sepsis (aOR 1.88), pneumonia (aOR 1.69), multiorgan failure or shock (aOR 1.80), and venous thromboembolism (aOR 2.06). Hospital charges were also higher (adjusted beta USD 17,497), whereas urinary tract infection odds were lower (aOR 0.68). DISCUSSION: Maintenance dialysis was associated with greater in-hospital morbidity and mortality among CMI-coded revascularization hospitalizations. The inability to distinguish stable from acute-on-chronic CMI limits interpretation as an elective cohort. Findings support individualized perioperative assessment without establishing causation or optimal treatment timing.