• Julio C Furlan, Michael G Fehlings, and B Catharine Craven.
• Department of Medicine, Division of Physical Medicine and Rehabilitation, University of Toronto, Toronto, Ontario, Canada.
• Neurosurgery. 2019 Jun 1; 84 (6): 1251-1260.

BackgroundAging of the population has prompted an escalation of service utilization and costs in many jurisdictions including North America. However, relatively little is known on the economic impact of old age on the management of acute spine trauma (AST).ObjectiveTo examine the potential effects of age on the service utilization and costs of the management of patients with acute spine trauma.MethodsThis retrospective cohort study included consecutive patients with AST admitted to an acute spine care unit of a Canadian quaternary university hospital between February, 2002 and September, 2007. The study population was grouped into elderly (≥65 yr) and younger individuals. All costing data were converted and updated to US dollars in June/2017.ResultsThere were 55 women and 91 men with AST (age range: 16-92 yr, mean age of 49.9 yr) of whom 37 were elderly. The mean total hospital costs for initial admission after AST in the elderly (USD $19 338 ± $4892) were significantly greater than among younger individuals (USD $13 775 ± $1344). However, elderly people had significantly lower per diem total, fixed, direct, and indirect costs for AST than younger individuals. Both groups were comparable regarding the proportion of services utilized in the acute care hospital.ConclusionGiven the escalating demand for surgical and nonsurgical spine treatment in the age of aging population, the timely results of this study underline key aspects of the economic impact of the spine care of the elderly. Further investigations are needed to fulfill significant knowledge gaps on the economics of caring for elderly with AST.Copyright © 2018 by the Congress of Neurological Surgeons.

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