Clinical Data, Laboratory Investigations and Electrocardiographic Changes as Predictors of Mortality in Acute Aluminum Phosphide Poisoning

Abstract

Aluminum phosphide (AlP) is one of the fumigants which is widely used in Egypt. Limited data is available on the predictors of mortality in ALP poisoned patients. So, the aim of this work was to evaluate the role of clinical data, laboratory investigations and ECG findings in predicting mortality in these cases. A cohort retrospective study was conducted on 113 cases of ALP poisoning admitted to Tanta Poison Control Unit. History, clinical data and results of laboratory investigations were recruited. Seventy seven cases died. There was a significant difference between survivors and non- survivors as regards mode of poisoning, GCS, vital signs (except the heart rate), the presence of ECG abnormalities, pH, HCo3, K and creatine level and white blood cell count. The multivariate analysis logistic regression revealed that the presence of ECG changes and the pH level are the only independent variables that can predict mortality. Analysis of receiver operating curve of blood pH level revealed a good area under the curve (AUC) of 0.881. At a cut off value of ≤7.28 the blood pH level had a sensitivity of 71.43. It was concluded that ALP poisoning causes high mortality rate. Mortality could be predicted by ECG changes and the blood pH level. At a cut off value of ≤7.28 the blood pH level was able to predict mortality. Assessment of ECG and blood pH is highly recommended in cases of ALP poisoning for early prediction of mortality.