The Saudi CABG Audit and Registry (SCAR) is a prospective, multicenter national clinical quality registry designed to systematically collect perioperative and long-term outcome data for all patients undergoing coronary artery bypass grafting (CABG) in Saudi Arabia. The registry will begin with a pilot phase in selected tertiary cardiac centers and will progressively expand to national coverage. SCAR captures detailed information on patient demographics, cardiac status, operative techniques, postoperative outcomes, and 1-year follow-up, including patient-reported quality-of-life measures (EQ-5D and SF-36). The aim is to establish a standardized national platform for benchmarking, quality improvement, and real-world evidence generation to support clinical decision-making and health policy development in cardiac surgery. Data are collected prospectively through secure electronic systems, anonymized before central storage, and analyzed using standardized definitions aligned with international registries such as STS and E-CABG.
Study Type
OBSERVATIONAL
Enrollment
3,000
The intervention consists of systematic, prospective collection of standardized clinical, operative, and follow-up data for all adult patients undergoing coronary artery bypass grafting (CABG) at participating centers. Data are recorded across predefined time points, including preoperative assessment, intraoperative details, postoperative in-hospital outcomes, and follow-up at 30 days, 3 months, 6 months, and 1 year. Variables include demographics, comorbidities, cardiac status, operative technique, complications, readmissions, mortality, and patient-reported quality-of-life measures (EQ-5D and SF-36). No treatments are assigned. The registry functions solely as an observational platform for quality improvement, benchmarking, and long-term outcome monitoring.
Incidence of In-hospital mortality
In-hospital all-cause mortality following coronary artery bypass grafting (CABG), recorded from the time of surgery until discharge. Mortality will be determined using standardized definitions aligned with major cardiac surgery registries such as STS and E-CABG.
Time frame: From date of surgery through hospital discharge, an average of 7-10 days.
Incidence of 30-day major adverse cardiac and cerebrovascular events (MACCE)
Composite endpoint including 30-day all-cause mortality, stroke, and myocardial infarction after coronary artery bypass grafting (CABG). Event definitions follow standardized criteria used in major cardiac surgery registries, including STS and E-CABG.
Time frame: 30 days post-surgery
Incidence of Deep sternal wound infection (DSWI)
Incidence of deep sternal wound infection following coronary artery bypass grafting (CABG), defined according to Centers for Disease Control and Prevention (CDC) criteria. Includes infections involving muscle, bone, or mediastinum requiring surgical intervention, antibiotics, or drainage.
Time frame: From surgery until 30 days post-operation
Unplanned reoperation for bleeding, tamponade, or graft-related technical failure
Incidence of unplanned return to the operating room after coronary artery bypass grafting (CABG) due to postoperative bleeding, cardiac tamponade, or graft-related technical failure. Events follow standardized definitions aligned with international cardiac surgery registries.
Time frame: Perioperative/Periprocedural
Intensive care unit (ICU) length of stay
Duration of postoperative stay in the intensive care unit following CABG surgery, measured in hours or days. Includes all ICU readmissions during the index hospitalization.
Time frame: From the date of surgery through initial ICU discharge (average of 3-5 days).
Total hospital length of stay
Duration of hospitalization from the day of surgery until discharge, measured in days. Includes all in-hospital recovery time after CABG.
Time frame: From the date of surgery through hospital discharge (average of 7-10 days).
Duration of mechanical ventilation
Total time on postoperative mechanical ventilation following CABG surgery, measured in hours. Includes any episodes of re-intubation requiring ventilatory support.
Time frame: From completion of surgery through extubation, an average of 12-24 hours
Incidence of 30-day readmission
Incidence of all-cause hospital readmission occurring within 30 days of discharge after CABG surgery.
Time frame: Within 30 days post-discharge
Number of Participants with Post Operative Acute kidney injury (AKI)
Occurrence of acute kidney injury following CABG, defined according to KDIGO criteria (increase in serum creatinine ≥0.3 mg/dL within 48 hours, ≥1.5× baseline within 7 days, or urine output \<0.5 mL/kg/h for 6 hours).
Time frame: From date of surgery through hospital discharge, an average of 7-10 days.
Incidence of New renal replacement therapy Initiation
Initiation of postoperative renal replacement therapy (intermittent dialysis or continuous renal replacement therapy) that was not required preoperatively.
Time frame: From date of surgery through hospital discharge, an average of 7-10 days.
Number of Participants with post operative New-onset atrial fibrillation
Incidence of atrial fibrillation requiring medical or procedural intervention following CABG, documented on electrocardiography or continuous telemetry.
Time frame: From date of surgery through hospital discharge, an average of 7-10 days.
Blood product utilization
Number and type of transfused blood products (red blood cells, plasma, platelets, cryoprecipitate) during and after CABG surgery.
Time frame: Intraoperative through 24 hours post-surgery
One-year survival
All-cause survival at 1 year following CABG surgery, assessed through clinical follow-up and health records.
Time frame: 1 year post-surgery
One-year MACCE
Composite of all-cause mortality, stroke, myocardial infarction, and repeat revascularization occurring within 1 year after CABG.
Time frame: 1 year post-surgery
Return to work or usual activity
Proportion of patients who resume employment or routine daily activity within 1 year after CABG.
Time frame: 1 year post-surgery
EuroQol-5 Dimension (EQ-5D)
Change in health-related quality of life after coronary artery bypass grafting (CABG), measured using the EuroQol 5-Dimension (EQ-5D) questionnaire. The EQ-5D index score ranges from 0 to 1, where 0 represents the worst possible health state and 1 represents the best possible health state. Higher scores indicate better health-related quality of life. The EQ-5D will be administered at baseline, 6 months, and 1 year to evaluate changes over time.
Time frame: Baseline, 6 months, 1 year
Short Form Health Survey (SF-36)
Change in health-related quality of life after coronary artery bypass grafting (CABG), measured using the 36-Item Short Form Health Survey (SF-36). Each of the eight domains is scored from 0 to 100, where 0 represents the worst health status and 100 represents the best health status. Higher scores indicate better functional and mental health outcomes. The SF-36 will be administered at baseline, 6 months, and 1 year to assess longitudinal recovery.
Time frame: Baseline, 6 months, and 1 year post-surgery
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