Predictors of Prognosis in Acute Aluminum Phosphide Poisoning

Document Type : Original Article


1 Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Tanta University, Tanta, Egypt,

2 Internal Medicine Department, Alnahdah Hospital, Muscat, Oman

3 Cardiology Department, Faculty of Medicine, Tanta University, Tanta, Egypt


Aluminum phosphide (AP) is a highly toxic pesticide that is commonly used for grain preservation. Acute AP poisoning is a serious public health problem and a real challenge for physicians in developing countries because of the high rates of morbidity and mortality. This study was conducted to identify predictors that might be useful in determination of prognosis for cases of acute AP intoxication. All cases of aluminum phosphide poisoning that had been referred to Tanta University Poison Control Center from March 2013 to February 2015 were included. Patients were subjected to full history taking including demographic features, and their clinical examination data were reported. Electrocardiography, serum cardiac troponin, arterial blood gases, complete blood count were recorded, and their associations with the patients’ outcomes were evaluated. Forty cases (11 males and 29 females) of acute AP poisoning were included in this study. Mortality rate was 67.5%. A statistically significant association was found between each of abnormal electrocardiography findings, elevated serum troponin level, low blood pH, serum bicarbonate, and serum glucose with the risk of mortality. Other alarming risk factors included suicidal ingestion, altered consciousness, hypokalemia, and leukocytosis. It could be concluded that, patients presenting with one or more of these findings are at higher risk of mortality. Early anticipation of these risks by the attending physician may help proper early intervention and might minimize mortality and improve outcome in these cases.