Prognostic value of blood lactate and C-reactive protein levels in acute Phosphides poisoned patients admitted to Menoufia University Poison control Center

Document Type : Original Article

Authors

Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Menoufia University, Egypt

Abstract

Metal phosphides as a whole and aluminum phosphide (AlP) in particular, are potent pesticides. Although phosphides are highly toxic and had a high mortality, it cannot be discarded due to their wide-spectrum applications. The aim of the study was to evaluate the prognostic value of blood lactate and C-reactive protein (CRP) levels in acute phosphide poisoned patients admitted to Menoufia University Poison Control Center. This was an analytical cross-sectional study done on cases of acute phosphide poisoning admitted to Menoufia Poison Control Center (MPCC) from the 1st of August 2022 to 31 December 2022 which fulfilled the inclusion criteria. Patient's data were collected in clinical sheets after taking written consent from patients or their guardians.  Only moderately and severely poisoned patients were included in the study according to Poison Severity Score. History, clinical examination, and Echocardiography were performed. Blood samples were taken for routine laboratory investigations and measuring blood lactate and CRP levels. A total of 57 patients (26 males and 31 females) were included in the present study. In all cases, the manner of poisoning was suicide. The age in non survivors (85.9%) ranged between 14-63 years while in survivors (14.1%) was 17-39 years.  Increase tablet number, low pH, low PO₂, high respiratory rate, low temperature, low diastolic blood pressure, high pulse rate, low ejection fraction, low potassium level, high CRP and blood lactate levels were significant predictors for phosphide poisoning mortality.  Aluminum phosphide is highly toxic with a high mortality rate. CRP and blood lactate levels can be used as predictors for mortality.

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