Purpose: To establish whether a ten-factor METABOLICS score can predict hospital impact of Index Laparoscopic Cholecystectomy (ILC) Methodology: Patients who underwent ILC at MMH in 2022 were analysed. Low METABOLICS was defined as a score of 0-2 and high METABOLICS >2. Hospital impact was determined by length of stay (LOS), operating time (OT), number of investigations, and major complications. Statistical analysis was performed using R. Statistical methods included independent t-tests for continuous variables and Fisher’s exact test for binary variables. Multivariate regression analyses were performed. Results: Of 457 patients in the cohort 149 patients were in the low METABOLICS group and 308 patients were in the high METABOLICS group. Compared to low METABOLICS, high METABOLICS had a longer LOS (MD 1.74 days, p < 0.0001), longer OT (MD 16.51 minutes, p < 0.0001) and more investigations (MD 2.72 investigations, p < 0.0001). Low METABOLICS had a non-statistically significant reduction in odds of a major complication (OR = 0.50, 95% CI 0.14-1.41, p = 0.19). There were 3 (0.6%) conversions and one minor CBD injury. Multivariate linear regression analyses were significant for LOS (p < 0.0001), OT (p < 0.0001), and number of investigations (p < 0.0001). Conclusions: • High METABOLICS score had a significant hospital impact compared to low METABOLICS score. This was shown across LOS, OT time and number of investigations. • The awareness of a high METABOLICS risk may help reduce complications. 1. Hutchinson A, Wratten-Stone A, Poole G. “M.E.T.A.B.O.L.I.C.S”: A hospital impact score (HIS) for index laparoscopic cholecystectomy. (2023), Abstract Journal General Surgery. ANZ Journal of Surgery, 93: 56-83