Brazilian System for Cardiac Operative Risk Evaluation CABG

Grouping relevant demographic and clinical information at specific stratified levels, and in correlation with the required resource sets, represents the possibility to adapt, improve, and innovate in cardiac surgery programs. In this path, the pursuit of implementing large databases for continuous improvement cycles becomes the foundation of the entire process. In Brazil, where structural and socioeconomic differences are significant, the standardization and sustainability of a large database become a major challenge. Projects like REPLICCAR (São Paulo Cardiovascular Surgery Registry) and BYPASS Registry, which were created to identify improvement opportunities, were temporary. The absence of a continuous multicenter registry makes it difficult to understand risk-adjusted patient outcomes and to implement cost-effective quality initiatives. For example, in 2022, the Ministry of Health launched the QualiSUS Cardio program, which began to consider hospital reimbursement not only in terms of surgical volume but also in relation to mortality, length of stay, and readmission rates after cardiac surgery. Changes like this already occur in various scenarios where payers, whether public or private, seek reimbursement through value-based models. However, for this to happen, the results need to be adjusted to patient risk. Otherwise, hospitals treating more severe patients would be at a disadvantage. This study aims to develop CABG-BraSCORE, a risk score to stratify patients referred for CABG surgery, adjusting outcomes to patient risk, and seeking continuous improvement for cardiac surgery programs in Brazil.

NCT Number	NCT07293533
Lead Sponsor	University of Sao Paulo General Hospital Collaborators: Instituto Nacional de Cardiologia de Laranjeiras, Beneficência Portuguesa de São Paulo, Santa Casa de Misericórdia de Marília, Professor Fernando Figueira Integral Medicine Institute, Hospital do Coração de Messejana Dr. Carlos Alberto Studart, Instituto de Cardiologia do Rio Grande do Sul, Irmandade da Santa Casa de Misericordia de Curitiba, Hospital Universitário do Maranhão - MA, Hospital do Coração Alagoano Prof. Adib Jatene, Irmandade da Santa Casa de Misericordia de Sao Paulo, Hospital São Francisco de Assis na Providência de Deus - RJ, Hospital Universitario Pedro Ernesto, Cardiac Emergency Hospital of Pernambuco, Hospital Geral de Cuiabá, Hospital Beneficente Portuguesa de Belém, Pronto-Socorro Cardiológico Universitário de Pernambuco, Hospital Alberto Urquiza Wanderley de João Pessoa, Hospital e Maternidade Marieta Konder Bornhausen, Hospital Arquidiocesano Consul Carlos Renaux, Hospital Universitário São Francisco na Providência de Deus (HUSF), Hospital Regional de Jundiaí, Hospital Ruy Azeredo, Hospital de Base, Hospital São Vicente de Paulo, Hospital das Clínicas da UFMG, Hospital de Cirurgia, Hospital Universitário (USP Riberão Preto), Fundação Hospital do Coração Francisca Mendes, Hospital Dom Helder Câmara, Hospital Santa Casa de Curitiba, Hospital São Vicente de Paulo - Jundiai
Conditions	CABG-patients
Enrollment	2,400 participants
Start Date	2024-04-01
Primary Completion	2026-05-01 (estimated)
Study Completion	2026-07-30 (estimated)
Updated on ClinicalTrials.gov	2025-12-19