Peri-operative metabolomic alterations predict post-operative complications and hospital stay in colorectal cancer patients

Purpose: This study aimed to explore whether the peri-operative metabolomics correlates with post-operative complications and hospital stay in colorectal cancer (CRC) patients. Materials and Methods: In this observational study, we collected information of the CRC patients enrolled from Jan 2024 to Dec 2024. We evaluated the pre-operative and ratios of post-operative to pre-operative metabolomic profiles to investigate their associations with post-operative complications and length of hospital stay. Logistic regression and linear regression were used to find independent indicators for post-operative complications and length of hospital stay. Results: A total of 243 CRC patients was included in this study. Prolonged surgical time, comorbidity of hypertension, increased tumor size, pre-operative 2-Aminobutyric acid, pre-operative glucose, higher levels of creatine ratio and H2TG ratio were independently associated with a higher risk of post-operative complications. As for post-operative hospital stay, surgical time, V3PL ratio, L4TG ratio, and 2-Hydroxybutyric acid ratio were independent predictors. Moreover, integrating both clinical and metabolic profiles demonstrated the best predictive performance for post-operative complications, and length of hospital stay. Conclusion: Peri-operative metabolomics were significantly associated with post-operative complications and hospital stay in CRC patients. Integrating metabolic biomarkers with clinical parameters demonstrated the best predictive performance.