In the past, hotfix release typically targetted a couple of bugs but recently we're seeing more and more hotfixes from NVIDIA that fix a long list of bugs. The new 461.81 hotfix has patches for seven issues.
Usually, I recommend skipping the Hotfix releases unless you experience one of the bugs listed below. In this case, the hotfix resolves some issues that may impact a lot of users. For example, NVIDIA has fixed a bug that can result in stuttering when you're moving around windows of desktop applications. Similarly, the green team fixed an issue that caused random flickering across the top of the display on some configurations with the GeForce GTX 1660 Super. There are also some game-specific updates, including a patch that reduces a stutter issue with Fortnite.
- [Fortnite] Shader cache optimizations to reduce intermittent stutter on some PC configurations 
- [GeForce GTX 1660 Super]: Random flickering may appear across the top of the monitor on some PC configurations. 
- [Vulkan] Red Dead Redemption 2 may display pixelated black dots 
- Some desktop applications may stutter when moving around the window on some PC configurations 
- Enabling NVIDIA Surround with 4K HDMI 2.1 TVs may fail 
- [Rocket League] Matches may take longer to load 
- [Detroit: Become Human] Game may crash when launched with Image Sharpening enabled