Development of a National Clinical Registry for CABG Surgery in Saudi Arabia-The SCAR Project

Background: Coronary artery disease is a leading cause of morbidity and mortality in Saudi Arabia. No national mechanism exists for standardized CABG outcome surveillance. The Saudi CABG Audit and Registry (SCAR) was established to address this gap. Methods: SCAR is a prospective multicenter clinical quality registry enrolling consecutive patients undergoing isolated or combined CABG across Saudi Arabia. The dataset captures more than 100 variables spanning demographics, comorbidities, operative details, in-hospital outcomes, and longitudinal follow-up to one year. Primary outcomes include in-hospital mortality, 30-day major adverse cardiac and cerebrovascular events (MACCE), deep sternal wound infection, and unplanned reoperation. Results: The registry incorporates structured follow-up at 30 days, 3 months, 6 months, and one year, governed through three national committees overseeing data quality and dissemination. A four-tier analytical framework progresses from descriptive analyses through risk-adjusted benchmarking, validation of international risk models, and future development of a locally derived risk prediction model. Implementation commences with a pilot phase enrolling 100-150 consecutive procedures across four centers over three months. Conclusions: SCAR represents the first dedicated national CABG registry in Saudi Arabia. Through risk-adjusted benchmarking and structured feedback, the registry may support quality improvement, multicenter research, healthcare planning, and development of locally relevant risk stratification tools.