Predictive Factors of Mortality in Acute Aluminum Phosphide Poisoning: 5 Years Retrospective Study in Tanta Poison Control Unit

Abstract

Introduction: Aluminum phosphide (ALP) is a widely used rodenticide for grain preservation. Acute aluminum phosphide poisoning became one of the serious public health problems especially in developing countries due to its high mortality rates. Aim of the work: The aim of the present study was to evaluate the predictive factors of mortality from acute ALP poisoned cases admitted to Tanta Poison Control Unit in a 5 years interval from the start of January 2012 to the end of December 2016. Patients and methods: This retrospective study was performed on medical records of acute ALP poisoned patients admitted to Tanta Poison Control Unit during the 5 years period. Patients were divided according to their outcome into survivors and non-survivors. For all patients; sociodemographic data, toxicological data, physical examination, laboratory investigation and therapeutic intervention were recorded to evaluate their associations with the patients’ outcome. Results: During the five years period, 105 acute ALP poisoned patients were admitted with 44.7% deaths. There was significant association between each of young age group, rural residence, suicidal ingestion, increase toxic dose and prehospitalization period with the risk of mortality. Other prognostic factors included altered consciousness, agitations, hypokalemia, hypernatremia, hyperglycemia, elevated (liver enzymes, blood urea& serum creatinine), need of mechanical ventilation, increased vasoactive drug administration and low magnesium sulphate administration were also associated with poor outcome. Moreover, presence of abnormal ECG, metabolic acidosis and low systolic blood pressure at admission were associated with high risk of mortality (odd ratios were 48.488, 10.251 and 0.964 respectively). Conclusion: Early recognition of the alarming risk factors with proper medical intervention may improve patients’ outcome and decrease the mortality rate of acute aluminum phosphide poisoning. Recommendations: Owing to the increase mortality rates of ALP poisoning, it is recommended to make restrictions of its open sales and perform a safe manufacture forms in a not ingestible containers