The Austrian Adult Cardiac Surgery Registry: Structure and Governance of a National Quality Assurance System

Austria has maintained a national adult cardiac surgery registry since 2009, covering all centres performing adult cardiac surgery. The registry provides nationwide risk-adjusted benchmarking and represents the central instrument for quality monitoring in Austrian adult cardiac surgery. Its defining features include full national coverage, annual external auditing and deterministic linkage to the national death registry. National clinical registries have become essential instruments for monitoring quality of care, enabling risk-adjusted benchmarking and informing health policy decisions in cardiovascular medicine. Before 2000, data collection was fragmented and unstandardized, prompting, the Austrian Society for Cardio-Thoracic Surgery (ÖGHTG) to establish a Quality Assurance Working Group, and ultimately launch the national registry. The FFG-funded CARDIAC project (2004-2006) defined the registry’s architecture: decentralized clinical data ownership with a central anonymized dataset for benchmarking. Following evaluation of available risk models, EuroSCORE was selected and later replaced by EuroSCORE II in 2012.1 A national legal framework (BGBl II 433/2008) enabled mandatory data capture and the registry was launched in 2009 with participation of all nine adult cardiac surgery centres.2 Since 2011, complete national datasets have been available.