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P47 Survival after hospitalization for heart failure (HF) is  poorly described in the community setting, particularly after  accounting for the type of admission. We performed an interim analysis  (n=3,627) of data gathered from a 50% random sample of patients 35-84  years old who were discharged in 1995 from Twin Cities area hospitals  with an ICD9 428 code (HF). Patients were classified by case-type: I  (incident case, admitted for HF), II (prevalent case, admitted for HF),  III (incident case, developed HF during hospitalization), IV (prevalent  case, HF progression during hospitalization), and V (prevalent case,  hospitalization unrelated to HF). Follow-up through 1998 was performed  using a statewide death certificate registry. Thetable below shows  heterogeneity of short and long-term survival by case-type. Prevalent  cases with evidence of HF progression on admission (case-type II) or  during hospitalization (case-type IV) had the worst 3-year survival.  Patients with evidence of HF progression after an admission that was  unrelated to HF (case-types III and IV) had a higher 28-day mortality  than those admitted for HF (case-types I and II); however, these  differences dissipated after 3 years of follow-up. A hospital-based  perspective of the epidemiology of HF should consider the five  different case-types behind a HF discharge  code.Table 1.

Long-term Survival of Hospitalized Patients with a Heart Failure Discharge Code: Early Experience of a Community-Based Study