Heropnames bij atriumfibrilleren dalen, sterfte blijft stabiel — populatiestudie

BACKGROUND: 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. METHODS: We analyzed electronic health records from Clalit Health Services, Israel's largest healthcare provider, from 2008 to 2021. 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. RESULTS: 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). CONCLUSIONS: 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.