Background and Aims Atrial fibrillation (AF) and flutter are common causes of hospitalizations but contemporary long-term outcomes following these episodes are uncertain. This study assessed outcomes up to 10 years after an acute AF or flutter hospitalization. Methods Patients hospitalized acutely with a primary diagnosis of AF or flutter from 2008–17 from all public and most private hospitals in Australia and New Zealand were included. Kaplan–Meier methods and flexible parametric survival modelling were used to estimate survival and loss in life expectancy, respectively. Competing risk model accounting for death was used when estimating incidence of non-fatal outcomes. Results A total of 260 492 adults (mean age 70.5 ± 14.4 years, 49.6% female) were followed up for 1 068 009 person-years (PY), during which 69 167 died (incidence rate 6.5/100 PY) with 91.2% survival at 1 year, 72.7% at 5 years, and 55.2% at 10 years. Estimated loss in life expectancy was 2.6 years, or 16.8% of expected life expectancy. Re-hospitalizations for heart failure (2.9/100 PY), stroke (1.7/100 PY), and myocardial infarction (1.1/100 PY) were common with respective cumulative incidences of 16.8%, 11.0%, and 7.1% by 10 years. Re-hospitalization for AF or flutter occurred in 21.3% by 1 year, 35.3% by 5 years, and 41.2% by 10 years (11.6/100 PY). The cumulative incidence of patients undergoing catheter ablation of AF was 6.5% at 10 years (1.2/100 PY). Conclusions Patients hospitalized for AF or flutter had high death rates with an average 2.6-year loss in life expectancy. Moreover, re-hospitalizations for AF or flutter and related outcomes such as heart failure and stroke were common with catheter ablation used infrequently for treatment, which warrant further actions.

中文翻译：

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因心房颤动或扑动住院后的长期结果

背景和目标 心房颤动 (AF) 和扑动是住院的常见原因，但这些事件后的当代长期结果尚不确定。这项研究评估了急性房颤或心扑住院后长达 10 年的结果。方法 纳入 2008-17 年澳大利亚和新西兰所有公立医院和大多数私立医院因初步诊断为房颤或扑动而急性住院的患者。 Kaplan-Meier 方法和灵活的参数生存模型分别用于估计生存和预期寿命损失。在估计非致命结果的发生率时，使用了考虑死亡的竞争风险模型。结果 共有 260 492 名成年人（平均年龄 70.5 ± 14.4 岁，49.6% 女性）接受了 1 068 009 人年 (PY) 的随访，其中 69 167 人死亡（发病率 6.5/100 PY），生存率为 91.2% 1 年时为 72.7%，5 年时为 72.7%，10 年时为 55.2%。预计预期寿命减少 2.6 年，即预期寿命的 16.8%。因心力衰竭（2.9/100 PY）、卒中（1.7/100 PY）和心肌梗死（1.1/100 PY）再住院的情况很常见，10 年累积发生率分别为 16.8%、11.0% 和 7.1%。 1 年时因 AF 或扑动而再次住院的比例为 21.3%，5 年时为 35.3%，10 年时为 41.2%（11.6/100 PY）。接受房颤导管消融治疗的患者 10 年累积发生率为 6.5% (1.2/100 PY)。结论 因 AF 或心扑住院的患者死亡率较高，预期寿命平均缩短 2.6 年。此外，因房颤或扑动以及心力衰竭和中风等相关后果而再次住院的情况在不经常使用的导管消融治疗中很常见，这需要采取进一步的行动。