Abstract Body (Do not enter title and authors here): BACKGROUND: Adults with heart failure (HF) are becoming more and more prevalent. The location of death and related
disparities in these patients are poorly understood.

AIM: The purpose of the study was to look at the locations of adult deaths from HF and identify any age, race,
or ethnicity-related variations over a 25-year period.

METHODS: The Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research
Database provided death certificate data and the National Center for Health Statistics provided
individual-level mortality data for the trend-level analysis of adults aged (20-64 and 65+ years)
conducted from 1999-2023. Hospital, home, hospice and nursing home/long-term care were the
categories for the places of death.

RESULTS: Between 1999 and 2023, a total of 7,644,759 adult deaths from HF were recorded (87.9% White, 53.4%
female). HF-related deaths decreased from 1999 (3.60% and 143.6 AAMR) to 2010 (3.47% and 123.1
AAMR). From 2010 onwards, a gradual rise is seen, with the rate of HF deaths reaching 5.18% and 168.1
AAMR in 2023. Notably, deaths at home increased from 18.41% (50,648 of 275,132) in 1999 to 33.47%
(132,470 of 395,826) in 2023 and deaths in hospice/nursing homes increased from 30.95% (85,144 of
275,132) in 1999 to 34.71% (116,634 of 336,014) in 2017 and then sudden fall was observed until 2023
to 29.54% (116,931 of 395,826). Older adults (65+) were more likely to die in inpatient facilities. Gender,
ethnicity, and urbanization influenced the place of death, with males, whites, and those residing in large
metropolitan areas more likely to die in medical facilities.

CONCLUSION: Prioritize end-of-life planning for HF patients with poor prognosis, regardless of age, to improve quality
of life and death.