PP302 - RESTING ENERGY EXPENDITURE CHARACTERISTICS AND ASSOCIATION OF ENERGY DELIVERY WITH SHORT-TERM OUTCOMES FOLLOWING ABDOMINAL SURGERY: A LATENT PROFILE ANALYSIS

PP302

RESTING ENERGY EXPENDITURE CHARACTERISTICS AND ASSOCIATION OF ENERGY DELIVERY WITH SHORT-TERM OUTCOMES FOLLOWING ABDOMINAL SURGERY: A LATENT PROFILE ANALYSIS

T. Xie¹, W. Ma¹, Y. Lin¹, T. Lv¹, Y. Xiao¹, L. Zhang¹, X. Wang^1,*

¹Jinling Hospital, Medical School of Nanjing University, Nanjing, China

Rationale: Postoperative metabolic heterogeneity complicates energy target setting. Using latent profile analysis (LPA), we identified metabolic phenotypes in abdominal surgery patients and examined whether the association between the percentage of administered calories to measured resting energy expenditure (AdCal/REE%) and short-term outcomes differs across phenotypes.

Methods: Prospective cohort of 1,098 patients undergoing major abdominal surgery. REE was measured by indirect calorimetry on POD 1,3,5. LPA integrated demographic, clinical, laboratory, and surgical variables. Primary outcome: 30-day infectious complications. AdCal/REE%–outcome association was analyzed within each phenotype with interaction testing.

Results: Three phenotypes emerged. Phenotype-α (43.6%) : middle-aged, well-nourished, normometabolic. REE peaked on POD3 (1400 kcal/d). Phenotype-β (22.5%) : oldest, malnourished, hypometabolic. REE remained low (~1300 kcal/d). Phenotype-γ (33.7%) : severe inflammation, hypermetabolic. REE rose from POD1 (1381 kcal/d) to POD5 (1515 kcal/d). Infectious complications: 7.3% (α), 11.7% (β), 19.1% (γ). The AdCal/REE%–outcome relationship showed significant phenotype-specific heterogeneity (p for interaction <0.05), indicating the same caloric delivery confers different risks across phenotypes.

Conclusion: Three distinct metabolic phenotypes with unique REE trajectories and complication profiles were identified. The phenotype-specific association between AdCal/REE% and outcomes argues against uniform energy targets. Metabolic phenotyping enables individualized caloric delivery to optimize recovery after abdominal surgery.

Disclosure of Interest: None declared