Honglei Ju

Background/Aims: Type 2 diabetes mellitus (T2DM) is increasingly recognized as a factor that may influence the course of acute pancreatitis (AP), but its independent associations with severity and mortality remain uncertain. The study investigated the independent association of preexisting T2DM with disease severity and in-hospital mortality in individuals with AP. Materials and Methods: This multicenter retrospective cohort study included 4458 patients with AP from 3 medical centers. Patients were categorized into T2DM (n = 711) and non-T2DM groups (n = 3747). Demographic and clinical data were collected. Multivariable logistic regression analysis was used to evaluate the associations of T2DM with disease severity and in-hospital mortality after adjustment for potential confounders. Stabilized inverse probability of treatment weighting (sIPTW) analyses were performed to assess the robustness of the results. Results: Compared with the non-T2DM group, the T2DM group was older and had a significantly higher proportion of males, and higher prevalences of hypertension and chronic kidney disease. In multivariable analysis, T2DM was independently associated with increased disease severity (OR = 1.42, 95% CI: 1.19-1.69) but not with in-hospital mortality (OR = 1.14, 95% CI: 0.61-2.02). The sIPTW analysis yielded consistent findings, with T2DM remaining independently associated with increased disease severity but not with in-hospital mortality. Conclusion: Preexisting T2DM is independently associated with increased disease severity in patients with AP but not with in-hospital mortality. Cite this article as: Wu B, Ju H, He C, Wang W, Wang G. Type 2 diabetes increases severity but not mortality in acute pancreatitis: A large multicenter analysis. Turk J Gastroenterol. Published online September 07, 2026. doi: 10.5152/tjg.2026.26159.

Background: The Systemic Inflammation Response Index (SIRI) has demonstrated predictive capabilities for clinical outcomes in various diseases. However, its prognostic utility in decompensated liver cirrhosis (DLC) remains underexplored. This study aimed to investigate the association between SIRI and the risk of short-term (3 and 6 months) all-cause mortality in DLC patients. Methods: A total of 926 eligible patients with DLC from diverse etiologies was included in this study. In the initial cohort, the predictive accuracy of SIRI was evaluated using receiver operating characteristic (ROC) curve analysis. Patients were categorized into high- and low-SIRI groups based on the Youden index. Multivariable logistic regression analysis was employed to evaluate the independent association between SIRI and all-cause mortality. Restricted cubic spline (RCS) analysis was utilized to visualize the relationship between the continuous variable SIRI and mortality risk. These findings were validated in a validation cohort. Results: The initial cohort had mortality rates of 8.8% and 11.6% at 3 and 6 months, respectively. The SIRI level was significantly higher in the deceased group compared to the survival group. At both time points, SIRI was an independent indicator of all-cause mortality. RCS analysis demonstrated the risk of the risk of increased with an increase in SIRI value. The Validation cohort validated the independent association between higher SIRI levels and lower short-term all-cause mortality. Conclusion: This study’s findings underscore the prognostic value of SIRI in DLC patients, indicating that higher SIRI levels are significantly associated with short-term adverse outcomes.