{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:52:20Z","timestamp":1787028740228,"version":"build-2736575974"},"reference-count":54,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T00:00:00Z","timestamp":1763424000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Background: Heart failure with preserved ejection fraction (HFpEF) is a major cause of hospitalization and mortality in older adults. Sudden cardiac arrest (SCA) is a leading cause of death in this population, yet national trends in incidence, outcomes, and disparities remain poorly defined. Methods: We performed a retrospective cohort study using the National Inpatient Sample from 2016 to 2020. Hospitalizations for patients aged \u226565 years with HFpEF and in-hospital cardiac arrest (CA) were identified using ICD-10-CM codes. Demographics, comorbidities, hospital outcomes, and temporal trends were examined. The primary outcome was in-hospital mortality. Secondary outcomes included length of stay, hospital charges, and discharge disposition. Results: Among 7,738,108 HFpEF admissions, 93,440 (1.2%) involved CA. Incidence rose from 1.1% in 2016 to 1.5% in 2020 (36% relative increase). The median age was 81 years; 54% were female, 70% White, 19% Black, and 8% Hispanic. CA incidence increased across all groups, with the largest relative rises among Native American (1.0% to 1.9%), Black (1.7% to 2.3%), and Hispanic patients (1.4% to 2.0%). In-hospital mortality was high, increasing from 58.2% to 61.7% over the study period (p &lt; 0.001). Mortality rose most steeply among Black and low-income patients. Comorbidity patterns shifted toward greater metabolic complexity, including higher rates of complicated diabetes, hypertension, hyperlipidemia, and obesity. Conclusions: Elderly patients hospitalized with HFpEF are experiencing rising rates of in-hospital CA and persistently high mortality, with marked racial and socioeconomic disparities. These findings highlight the need for better risk stratification, targeted metabolic and inflammatory therapies, and more equitable care delivery.<\/jats:p>","DOI":"10.3390\/jpm15110559","type":"journal-article","created":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T10:02:13Z","timestamp":1763546533000},"page":"559","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Nationwide Trends in Demographics, Comorbidities, and Mortality Among Elderly Patients with Heart Failure with Preserved Ejection Fraction Hospitalized with Cardiac Arrest"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4298-6459","authenticated-orcid":false,"given":"Adil Sarvar","family":"Mohammed","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Central Michigan University, 1000 Houghton Ave, Saginaw, MI 48602, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0032-1130","authenticated-orcid":false,"given":"Maya Asami","family":"Takagi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of California (Davis), 4150 V Street, Sacramento, CA 95817, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Umera","family":"Yasmeen","sequence":"additional","affiliation":[{"name":"Department of Medicine, Mamata Medical College, Rotary Nagar, Khammam 507002, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-8526-9795","authenticated-orcid":false,"given":"Aashna","family":"Gandhi","sequence":"additional","affiliation":[{"name":"GCS Medical College, Hospital & Research Centre, Opposite Divisional Railway Manager\u2019s Office, NR Railway Station, Ahmedabad 380025, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-1293-6538","authenticated-orcid":false,"given":"Ayesha Firdous Shafiulla","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Tennessee Health Science Center, 956 Court Ave, Memphis, TN 38163, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9571-2603","authenticated-orcid":false,"given":"Apurva","family":"Popat","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Marshfield Clinic Health System, 1000 N Oak Ave, Marshfield, WI 54449, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5315-6426","authenticated-orcid":false,"given":"Rupak","family":"Desai","sequence":"additional","affiliation":[{"name":"Independent Researcher, Atlanta, GA 30033, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shrinivas","family":"Kambali","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, MyMichigan Medical Center, 1000 Houghton Ave, Saginaw, MI 48601, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-6673-4981","authenticated-orcid":false,"given":"Ahmad Khalil A.","family":"Koshak","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Tabuk, Prince Fahd Bin Sultan Rd, Tabuk 47512, Saudi Arabia"},{"name":"International Medical Center, JBRB4238, 4238 Nour Alhuda, Jeddah 23214, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sohaib","family":"Mandoorah","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, MyMichigan Medical Center, 1000 Houghton Ave, Saginaw, MI 48601, USA"},{"name":"Department of Critical Care Medicine, Central Michigan University, 1000 Houghton Ave, Saginaw, MI 48602, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"s24","DOI":"10.7861\/clinmedicine.18-2-s24","article-title":"Heart failure with preserved ejection fraction","volume":"18","author":"Harper","year":"2018","journal-title":"Clin. 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