Delayed care due to interhospital transfers significantly increases mortality and procedural severity in acute mesenteric ischemia.

• Of 39,690 AMI hospitalizations, 14.6% involved transfer, which correlated with higher complication rates.
• Transferred patients had 3.48 times the odds of bowel resection and 2.05 times higher in-hospital mortality after adjustments for age and comorbidities.

Early diagnosis and streamlined transfer protocols are crucial for improving outcomes in these patients.

• Transferred patients were often treated in facilities with fewer resources, emphasizing the need for organized regional care systems.