Forms and Appendices
Data Collection Forms
Data collection for the World Database for Pediatric and Congenital Heart Surgery (WDPCHS) began January 1, 2017.
PDF versions of the data collection forms can be found below.
Form Version: 1.0.7
Release Date: March 9, 2020
Institutional Practice Details
To be completed at the time of hospital enrollment. An updated form should be completed each January.
Tier 1 Surgery Form
To be completed for all Tier 1 surgeries. Form is due at time of surgery.
Tier 2 Surgery Form
To be completed for all Tier 2 surgeries. This is the only form required for Tier 2 surgeries. Form is due at time of surgery.
Tier 2 Discharge Form
To be completed at time of discharge or at 90 days post surgery for patients still in the hospital.
Demographics Form
This form should be completed at time of Tier 1 surgery. Only one form is required per patient.
Post Operative Events Form
To be completed at time of patient discharge from Tier 1 surgery or 90 days post surgery if patient is still in hospital.
Annual Follow-up Form
To be completed at time of one year follow-up for each Tier 1 surgery.
Death Form
To be complete at time of patient death for patients that have had a Tier 1 surgery.
Appendices
Appendix A.docx (Updated July 10, 2019)
Surgical Procedure Terms and Definitions
Appendix A.1 (Updated July 10, 2019)
Tier 1 Surgical Procedure Terms and Definitions
Appendix A.2 (Updated July 10, 2019)
Tier 2 Surgical Procedure Terms and Definitions
Appendix B (Updated July 10, 2019)
Diagnosis (International Paediatric and Congenital Cardiac Codes (IPCCC) and definitions)
Appendix C (Updated December 15, 2016)
Birth Country
Appendix D (Updated January 25, 2017)
Non Cardiac Congenital Anatomic Abnormality Terms and Definitions
Appendix E (Updated October 16, 2016)
Chromosomal Abnormalities: Terms and Definitions
Appendix F (Updated July 10, 2019)
Pre-Operative Risk Factors
Appendix G (Updated January 25, 2017)
Syndromes Terms and Definitions
Appendix H (Updated April 24, 2017)
Complications
Appendix I(1) (Updated November 4, 2017)
Example Patient Log
