Key result
Recent post-AF hospitalizations fall ~13% over 14 years despite unchanged one-year mortality.
Why the study?
Atrial fibrillation causes substantial hospitalization and healthcare burden, but temporal trends in outcomes after initial AF hospitalization were not well characterized.
Cohort (n=12,141)
Yes
Relative Risk: 0.87 (95% CI 0.79–0.95)
Over a 14-year period, one-year mortality following initial AF hospitalization remained stable, but all-cause and AF-specific hospitalizations significantly declined, particularly in younger patients.
Declining readmissions with stable AF mortality may reflect better care; extends observational trends but remains hypothesis-generating without prospective confirmation.
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 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. 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.
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Moshkovits et al. (2026) conducted a cohort in Atrial fibrillation (n=12,141). Hospitalization in 2020-2021 vs. Hospitalization in 2008/2009 was evaluated on All-cause hospitalization (RR 0.87, 95% CI 0.79-0.95). Over a 14-year period, one-year mortality following first AF hospitalization remained stable, while all-cause hospitalizations declined significantly in 2020-2021 compared to 2008/2009 (RR 0.87; 95% CI 0.79-0.95).
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