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Introduction: Acute pancreatitis (AP) is a leading indication for hospital admission. The relationship between AP and diabetes mellitus (DM) is becoming increasingly recognized. Many patients with DM have comorbid conditions (ex. heart and renal disease) that may increase the risk of severe pancreatitis or pancreatitis outcomes. We aim to identify the impact of DM on acute pancreatitis hospital outcomes including organ failure, readmission, and death. Methods: We identified patients hospitalized for acute pancreatitis between January 2015 and March 2021 using our prospective observational cohort. We included patients who had an episode of acute pancreatitis with or without pre-existing DM. Outcomes of interest included severity of pancreatitis, necessity of an intensive care unit (ICU) stay, organ failure, readmission, and death. Information on demographics, medical history, biochemical data, severity of the pancreatitis episode (Revised Atlanta Classification), and imaging were obtained for analysis. Logistic regression was used for analysis. Results: A total of 1340 unique patients were included in the analysis. 313 (23.4%) of the patients had pre-existing DM while 1027 (76.6%) did not. The overall cohort was 46.8% female and 81.3% Hispanic. The mean age in the patients with pre-existing DM was 53 ( 6 14) years old, while the non-diabetic cohort was 43 (6 15) years old. Patients with diabetes mellitus were significantly more likely to have moderate-tosevere pancreatitis ]. With regards to hospital outcomes, the diabetes cohort were more likely to have an intensive care unit (ICU) stay [2.26 (1.65-3.11)], and necessity of ICU interventions such as vasopressors [5.06 (2.25-11.38)], intubation [2.21 (1.13-4.35)], and renal replacement therapy (RRT) [4.77 (1.92-11.88)]. No significant difference was seen in readmission within 30 days [0.79 (0.51-1.23)] but patients with diabetes were more likely to have hospitalization result in death [3.49 (1.41-8.60)]. Conclusion: Within our acute pancreatitis population, patients with diabetes mellitus were more likely to have both local and systemic complications as well as necessity of more invasive hospital interventions such as intubation and vasopressors compared to their non-diabetic counterparts. These results emphasize the importance of adequately controlling patients' underlying diabetes to minimize risk of hospital complications (Table ).

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Figure 1. (A) KPC pancreas sample placed on Novascan's electrode array for a series of spectral bioimpedance measurements. A zoom in of the electrode with a pancreas sample is also shown. White rectangles indicate multiple locations measured across the sample. Spectral impedance scans for a control mouse (B) and a KPC mouse (C). The examination of CRF peak properties was used for cancer identification in pancreas samples. For the control mouse the CRF peaks fall below the threshold of 1 MHz, determining no cancer. For the KPC mouse several scans have CRF peaks above the threshold of 1 MHz, determining cancer presence.

alternative method for sample collections in PCLs. We conducted a systemic review and meta-analysis on the studies that compared EUS-FNA and EUS-TTNB for adequate sampling and diagnostic accuracy in patients with PCLs. Methods: We performed a comprehensive search of the databases: PubMed/MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials from inception through May 10th, 2022. We considered randomized controlled trials, cohort studies, and case-control studies. We excluded abstracts, animal studies, case reports, reviews, editorials, and letters to editors. The primary outcome was sample adequacy which is defined as the presence of enough sample for histopathological evaluation. The secondary outcome was sample accuracy which is defined as the ability to have a definite diagnosis. The random-effects model was used to calculate the risk ratios (RR) and confidence intervals (CI). A p value , 0.05 was considered statistically significant. Heterogeneity was assessed using the Higgins I 2 index. Results: Nine observational studies involving 520 patients were included in the meta-analysis. The rate of sample adequacy was significantly higher in the EUS-TTNB group compared to the EUS-FNA group (RR 1.64, 95% CI 1.19-2.26, p 50.003, I 2 5 95%) (Figure 1A). Only four studies compared the accuracy rate between the EUS-TTNB method and the EUS-FNA group. The diagnostic accuracy was significantly higher in the EUS-TTNB group compared to the EUS-FNA group (RR 2.03, 95% CI 1.13-3.65, p 5 0.02, I 2 5 87%) (Figure 1B). Conclusion: Our meta-analysis demonstrated that the rates of both sample adequacy and accuracy were higher in the EUS-TTNB group compared to the EUS-FNA group. EUS-TTNB should be considered where applicable clinically for improving the diagnostic yield in patients undergoing evaluation of PCLs. Further randomized controlled trials are needed to confirm our findings.[0046] Figure 1. a) sample adequacy rate b) diagnostic accuracy rate S47 Presentation, Management, and Outcomes in Patients With Concomitant Acute Pancreatitis and Acute Kidney Injury