Temporal trends of outcomes following first hospitalization due to atrial fibrillation- a population-based study

Atrial fibrillation (AF) represents a substantial cause of hospitalization and healthcare burden. This study aimed to examine temporal trends in outcomes following an initial hospitalization for AF.

We analyzed electronic health records from Clalit Health Services, Israel's largest healthcare provider, from 2008 to 2022. The study included 12,141 patients with newly diagnosed AF requiring hospitalization. We examined one-year outcomes including all-cause mortality, hospitalizations, bleeding events, and cerebrovascular accidents, stratified by age and sex.

One-year mortality rates remained stable at 11.3% over the study period (adjusted RR per year: 1.01, 95% CI: 0.99-1.02). All-cause hospitalization rates (61.6%) declined significantly (adjusted RR 2008/2009 vs. 2020-2021: 0.87, 95% CI: 0.79-0.95), with a more pronounced decrease in AF-specific readmissions (19.2%, adjusted RR: 0.24, 95% CI: 0.22-0.26). Younger patients (aged <70) showed a greater reduction in All-cause hospitalization rates and in AF-specific hospitalization rates compared to older age groups (RR 0.60, 95% CI: 0.55-0.66; RR 0.27, 95% CI: 0.23-0.30, respectively).

While mortality rates following AF hospitalization remained unchanged, there was a significant reduction in hospitalizations, particularly AF-specific readmissions among younger patients. Targeted improvements in bleeding and cerebrovascular events were observed in specific subgroups, suggesting the potential benefit of tailored management strategies.