National Trends in Atrial Fibrillation Hospitalizations, Readmissions, and Mortality, 2010 to 2022

Area of Science:

• Cardiovascular Medicine
• Public Health
• Health Economics

Background:

• Atrial fibrillation (AF) is a primary driver of acute cardiovascular hospitalizations, yet contemporary national data on trends and risk factors for readmission and mortality are scarce.
• Understanding these trends is crucial for improving patient outcomes and managing healthcare resources effectively.

Purpose of the Study:

• To analyze national trends in hospitalizations for atrial fibrillation (AF).
• To identify key risk factors associated with 30-day readmission and in-hospital mortality following index AF admission.

Main Methods:

• Utilized nationally representative, survey-weighted hospitalization data from 2010 to 2022.
• Employed cluster-adjusted multivariable logistic regression to determine risk factors for 30-day readmission and in-hospital mortality.

Main Results:

• Over 6.1 million AF hospitalizations occurred between 2010 and 2022, with a 16.1% 30-day readmission rate and 0.96% in-hospital mortality.
• Renal disease, public insurance (Medicare/Medicaid), lower income, COPD, heart failure, prior MI, and female sex were significant predictors of adverse outcomes.
• Total costs for AF hospitalizations reached $7.2 billion in 2022.

Conclusions:

• AF hospitalizations and readmissions showed a modest net increase from 2010-2022, with a dip during 2014-2020 and a rebound post-COVID-19.
• Age, comorbidities, and socioeconomic factors significantly influence 30-day readmission and in-hospital mortality in AF patients.
• Findings highlight the need for targeted interventions addressing patient comorbidities and socioeconomic determinants to reduce AF-related healthcare burden.