Mark Faul

Mark Faul
Centers for Disease Control and Prevention | CDC · National Center for Injury Prevention and Control, Division of Unintentional Injury Prevention

PhD, MA

About

89
Publications
18,541
Reads
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7,361
Citations

Publications

Publications (89)
Article
Introduction Approximately 27.5% of adults 65 and older fall each year, over 3 million are treated in an emergency department, and 32 000 die. The American College of Surgeons and its Committee on Trauma (ACSCOT) have urged trauma centers (TCs) to screen for fall risk, but information on the role of TC in this opportunity for prevention is largely...
Article
Background In response to the opioid crisis, over the last 10 years substantial strides have been made to increase the availability of evidence-based treatments for opioid use disorder, in particular buprenorphine maintenance, in the United States. Despite these worthwhile efforts, uptake rates of evidence-based treatment remain relatively low. As...
Article
Full-text available
Background After decades of liberal opioid prescribing, multiple efforts have been made to reduce reliance upon opioids in clinical care. Little is known about the effects of opioid prescribing policies on outcomes beyond opioid prescribing. Objective To evaluate the combined effects of multiple opioid prescribing policies implemented in a safety-...
Article
Background Understanding whether International Classification of Disease, 10th Revision, Clinical Modification (ICD-10-CM) codes can be used to accurately detect substance use can inform their use in future surveillance and research efforts. Methods Using 2015-2018 data from a retrospective cohort study of 602 safety-net patients prescribed opioid...
Article
Background:Opioid prescribing guidelines recommend reducing or discontinuing opioids for chronic pain if harms of opioid treatment outweigh benefits. As opioid discontinuation becomes more prevalent, it is important to understand whether opioid discontinuation is associated with heroin use. In this study, we sought to assess the association between...
Article
Studies have shown reduced life expectancy following moderate-severe traumatic brain injury (TBI) with death due to unintentional poisoning (UP) 11x higher following TBI than in the general population. The characteristics of those who die of unintentional poisoning are compared to those who die of other causes (OC) in a retrospective cohort who rec...
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Background After decades of increased opioid pain reliever prescribing, providers are rapidly reducing prescribing. We hypothesized that reduced access to prescribed opioid pain relievers among patients previously reliant upon opioid pain relievers would result in increased illicit opioid use. Methods and findings We conducted a retrospective coho...
Article
Introduction Research identifying pathways to heroin use has typically been conducted among urban populations. This study examined heroin initiation following pharmaceutical opioid use in three suburban/exurban Southern California counties. Methods Interviewer-administered surveys collected data among 330 participants (65.9 % male; 63.9 % non-Hisp...
Article
Objective: It is unclear if trauma center care is associated with improved outcomes in older adults with traumatic brain injury (TBI) compared to management at non-trauma centers. Our primary objectives were to describe the long-term outcomes of older adults with TBI and to evaluate the association of trauma center transport with long-term functio...
Article
Problem/condition: A 2017 report quantified the higher percentage of potentially excess (or preventable) deaths in nonmetropolitan areas (often referred to as rural areas) compared with metropolitan areas. In that report, CDC compared national, regional, and state estimates of potentially excess deaths among the five leading causes of death in non...
Article
Objective: To evaluate the accuracy of emergency medical services (EMS) provider judgment for traumatic intracranial hemorrhage (tICH) in older patients following head trauma in the field. We also compared EMS provider judgment with other sets of field triage criteria. Methods: This was a prospective observational cohort study conducted with 5 EMS...
Article
Drug overdose is the leading cause of unintentional injury-associated death in the United States. Among 70,237 fatal drug overdoses in 2017, prescription opioids were involved in 17,029 (24.2%) (1). Higher rates of opioid-related deaths have been recorded in nonmetropolitan (rural) areas (2). In 2017, 14 rural counties were among the 15 counties wi...
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As the opioid epidemic in the United States has continued since the early 2000s (1,2), most descriptions have focused on misuse and deaths. Increased cooperation with state and local partners has enabled more rapid and comprehensive surveillance of nonfatal opioid overdoses (3).* Naloxone administrations obtained from emergency medical services (EM...
Article
Importance Current guidelines conflict on the management of older adults who have blunt head trauma taking anticoagulant and antiplatelet medications. This is partially due to the limited data comparing patients who are taking these medications with those who are not. Objective To investigate the incidence of delayed traumatic intracranial hemorrh...
Article
Field triage guidelines recommend transport of head-injured patients on anticoagulants or antiplatelets to a higher-level trauma center based on studies suggesting a high incidence of traumatic intracranial hemorrhage (tICH). We compared the incidence of tICH in older adults transported by EMS with and without anticoagulation or antiplatelet use an...
Article
Background: Opioid medication to treat acutely injured patients is usual care in trauma settings. A higher prevalence of alcohol and other substance misuse in this population compared to the general population increases the vulnerability of such patients to both misuse of their prescribed opioids, and also unintentional opioid overdose. The primar...
Article
Background: Opioid overdoses are at epidemic levels in the United States. Emergency Medical Service (EMS) providers may administer naloxone to restore patient breathing and prevent respiratory arrest. There was a need for contemporary data to examine the number of naloxone administrations in an EMS encounter. Methods: Using data from the Nationa...
Article
Drug overdose is a leading cause of injury death in the United States; 47,055 fatal drug overdoses were reported in 2014, a 6.5% increase from the previous year (1), driven by opioid use disorder (2,3). Methadone is an opioid prescribed for pain management and is also provided through opioid treatment programs to treat opioid use disorders. Because...
Article
Study objective: Field triage guidelines recommend that emergency medical services (EMS) providers consider transport of head-injured older adults with anticoagulation use to trauma centers. However, the triage patterns and the incidence of intracranial hemorrhage or neurosurgery in these patients are unknown. Our objective is to describe the char...
Article
Purpose: This is a descriptive study. It determined the annual, national incidence of head injuries (TBI) to adults and children in motor-vehicle crashes. It evaluated NASS-CDS (National Automotive Sampling System-Crashworthiness Data System) for exposure and incidence of various head injuries in towaway crashes. It evaluated three health databases...
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Full-text available
Problem/condition: Higher rates of death in nonmetropolitan areas (often referred to as rural areas) compared with metropolitan areas have been described but not systematically assessed. Period covered: 1999-2014 DESCRIPTION OF SYSTEM: Mortality data for U.S. residents from the National Vital Statistics System were used to calculate age-adjusted...
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In 2014, the all-cause age-adjusted death rate in the United States reached a historic low of 724.6 per 100,000 population (1). However, mortality in rural (nonmetropolitan) areas of the United States has decreased at a much slower pace, resulting in a widening gap between rural mortality rates (830.5) and urban mortality rates (704.3) (1). During...
Article
Death rates by specific causes vary across the 50 states and the District of Columbia.* Information on differences in rates for the leading causes of death among states might help state health officials determine prevention goals, priorities, and strategies. CDC analyzed National Vital Statistics System data to provide national and state-specific e...
Article
Background WISQARS is an interactive, web-based data query system (WBDQS) that is accessible from the internet. It includes modules for fatal and non-fatal injuries, a separate module on violent deaths, and injury costs and maps. Data come from a variety of trusted sources, including national health surveys and health data repositories. CDC created...
Article
Background Prescription drug monitoring programs (PDMPs) and pill mill laws were implemented to reduce opioid-related injuries/deaths. We evaluated their effects on high-risk prescribers in Florida. Methods We used IMS Health’s LRx Lifelink database between July 2010 and September 2012 to identify opioid-prescribing prescribers in Florida (interve...
Conference Paper
This year we were delighted to have received over 90 abstracts from investigators and researchers from over 11 countries and from some of the world's leading academic and research institutions. Moreover, we continue to be pleased with the high quality of the research submitted and with the broad range of topics that truly reflect the advances now b...
Article
Objective: Guidelines suggest that Traumatic Brain Injury (TBI) related hospitalizations are best treated at Level I or II trauma centers because of continuous neurosurgical care in these settings. This population-based study examines TBI hospitalization treatment paths by age groups. Methods: Trauma center utilization and transfers by age group...
Article
Introduction: Among people aged ≥65 years, falling is the leading cause of emergency department visits. Emergency medical services (EMS) are often called to help older adults who have fallen, with some requiring hospital transport. Chief aims were to determine where falls occurred and the circumstances under which patients were transported by EMS,...
Article
Objective: To determine the situational circumstances associated with bystander interventions to render aid during a medical emergency. Methods: This study examined 16.2 million Emergency Medical Service (EMS) events contained within the National Emergency Medical Services Information System. The records of patients following a 9-1-1 call for em...
Article
Background: States have attempted to reduce prescription opioid abuse through strengthening the regulation of pain management clinics; however, the effect of such measures remains unclear. We quantified the impact of Texas's September 2010 "pill mill" law on opioid prescribing and utilization. Methods: We used the IMS Health LRx LifeLink databas...
Article
We determined the factors that affect naloxone (Narcan) administration in drug overdoses, including the certification level of emergency medical technicians (EMTs). In 2012, 42 states contributed all or a portion of their ambulatory data to the National Emergency Medical Services Information System. We used a logistic regression model to measure th...
Article
Traumatic brain injury (TBI) is a leading cause of death, and in a recent analysis it was found that nearly one-third of all injury-related deaths in the US have at least one diagnosis of TBI (CDC-Quickstats, 2010). This chapter presents the burden of TBI as regards age group, gender, costs, race, emergency department (ED) visits, hospitalizations,...
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The most effective use of trauma center resources helps reduce morbidity and mortality, while saving costs. Identifying critical infrastructure characteristics, patient characteristics and staffing components of a trauma center associated with the proportion of patients needing major trauma care will help planners create better systems for patient...
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This study sought to determine whether there are underlying dimensions common among traumatic brain injury (TBI) severity indices and, if so, the extent to which they are interchangeable when predicting short-term outcomes. The National Trauma Data Bank (NTDB) from 2007 to 2010 provided 77,470 unweighted adult cases with ICD-9-CM TBI codes that met...
Article
Diagnosis of cervical spine injury (CSI) is difficult in patients with an altered level of consciousness as a result of a traumatic brain injury (TBI). Patients with TBI and older adults are at increased risk for CSI. This study examined the various risk factors for CSI among trauma patients with TBI and whether adults who were older (≥55 years) we...
Article
Individuals aged 65 years and over have the highest rates of traumatic brain injury (TBI)-related hospitalizations and deaths, and older adults (defined variably across studies) have particularly poor outcomes after TBI. The factors predicting these outcomes remain poorly understood, and age-specific care guidelines for TBI do not exist. This study...
Article
Patients with severe traumatic brain injury (TBI), head Abbreviated Injury Scale (AIS) score of 3 or greater, who are indirectly transported from the scene of injury to a nontrauma center can experience delays to definitive neurosurgical management. Transport to a hospital with appropriate initial emergency department treatment and rapid admission...
Article
Traumatic brain injury (TBI) represents a serious subset of injuries among persons in the United States, and prehospital care of these injuries can mitigate both the morbidity and the mortality in patients who suffer from these injuries. Guidelines for triage of injured patients have been set forth by the American College of Surgeons Committee on T...
Article
Ambulance transport of injured patients to the most appropriate medical care facility is an important decision. Trauma centers are designed and staffed to treat severely injured patients and are increasingly burdened by cases involving less-serious injury. Yet, a cost evaluation of the Field Triage national guideline has never been performed. To ex...
Article
In the United States, injury is the leading cause of death for persons aged 1-44 years. In 2008, approximately 30 million injuries were serious enough to require the injured person to visit a hospital emergency department (ED); 5.4 million (18%) of these injured patients were transported by Emergency Medical Services (EMS). On arrival at the scene...
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Some studies have shown improved outcomes with helicopter emergency medical services (HEMS) transport, while others have not. Safety concerns and cost have prompted reevaluation of the widespread use of HEMS. To determine whether the mode of transport of trauma patients affects mortality. Data for 56,744 injured adults aged ≥ 18 years transported t...
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Full-text available
Traumatic brain injury (TBI) is a leading cause of death and disability in the United States. Approximately 53,000 persons die from TBI-related injuries annually. During 1989-1998, TBI-related death rates decreased 11.4%, from 21.9 to 19.4 per 100,000 population. This report describes the epidemiology and annual rates of TBI-related deaths during 1...
Article
After Hurricane Katrina and a decline in the living conditions at a major temporary shelter in New Orleans, Louisiana, residents were offered transport to a Mega-Shelter in Houston, Texas. Approximately 200,000 Gulf Coast residents were transported to Houston's Astrodome/Reliant Center Complex for appropriate triage and transfer to other shelter fa...
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Full-text available
IntroductionTraumatic Brain Injury (TBI) is an important public health problem in the United States (US) resulting in disabling conditions and long-term societal costs. Thus, there a compelling need for prevention, treatment and rehabilitation initiatives informed by national, population-based data.Objective To estimate the prevalence and incidence...
Article
The National Trauma Data Bank (NTDB) was developed as a convenience sample of registry data from contributing trauma centers (TCs), thus, inferences about trauma patients may not be valid at the national level. The NTDB National Sample was created to obtain nationally representative estimates of trauma patients treated in the US level I and II TCs....
Conference Paper
Purpose: To characterize national estimates of injuries treated in level I and level II trauma center hospitals compared to those treated in US hospital emergency departments (EDs) using data from the National Trauma Data Bank-National Sample Project (NTDB-NSP) and the National Electronic Injury Surveillance System-All Injury Program (NEISS-AIP)....
Conference Paper
Background. After Hurricane Katrina and a decline in the living conditions at a major New Orleans shelter, evacuees were bused to a Houston mega-shelter. The Katrina Clinic was quickly organized to treat acute injuries/illnesses and chronic conditions. The purpose of this analysis is to document the nature, extent and location of 1,130 injuries tre...
Article
A decade after promulgation of treatment guidelines by the Brain Trauma Foundation (BTF), few studies exist that examine the application of these guidelines for severe traumatic brain injury (TBI) patients. These studies have reported both cost savings and reduced mortality. We projected the results of previous studies of BTF guideline adoption to...