Trends in mortality after first hospitalization with Atrial Fibrillation diagnosis in Sweden 1987 to 2006

BackgroundTo examine trends in 3-year mortality after a first hospitalization with diagnosed atrial fibrillation in a large cohort with and without important comorbidities.MethodsThe Swedish Hospital Discharge and Cause of Death Registries were linked to investigate trends in mortality for all patients 35 to 84 years hospitalized for the first time with a discharge diagnosis (principal or contributory) of atrial fibrillation in Sweden during 1987 to 2006. We performed an analysis of temporal trends in mortality stratified for presence or absence of co-morbidities affecting survival.ResultsExactly 376,000 patients (56% male, mean age 72 years) with a first diagnosis of atrial fibrillation during 1987-2006 were identified and followed for 3 years. Patients with one or more of the prespecified comorbidities had the highest mortality and the largest absolute decline in mortality, but patients without these comorbidities had a slightly larger relative decline (absolute risk reduction in 3-year mortality (AAR) from 42.5 to 34.7%, Hazard Ratio (HR) 0.76; 95% confidence interval (95% CI) 0.74 to 0.77 versus ARR 16.2% to 11.7%, HR 0.71; 0.68 to 0.74. In patients aged below 65 years, with no comorbidities, there was minimal change in mortality, and they still had a 2 times increased mortality compared to the general population (SMR 1.95; 1.84 - 2.06).ConclusionsSurvival after a first hospitalization with a diagnosis of atrial fibrillation improved regardless comorbidities. Patients aged < 65 years old without diagnosed comorbidities still had a poor prognosis compared to the general population.