Severity factors of aluminium phosphide poisoning (Phostoxin®)

Objectives. - To determine characteristics of acute aluminum phosphide poisoning (AAIPP) and to evaluate its severity factors. Design study. - Retrospective cohort study. Patients and methods. - Consecutive cases of AAIPP admitted in medical ICU (Hospital Avicenne, Rabat, Morocco) between January 1992 and December 2002 were studied. AAIPP was identified by history, symptoms and toxicological results. Almost 50 parameters have been collected and compared between survivors and non-survivors groups. Data were analyzed using Fisher exact test and Mann-Whitney test. Results. - Twenty-eight patients were enrolled: 17 female and 11 male, average age = 24 +/- 11 years, SAPS II = 24.4 +/- 14.5. The ingested dose was 3.3 +/- 1.8 g. The self-poisoning was observed in 27 cases and delay before hospital admission was 11 13 hours. Mean Glasgow coma scale was 14 +/- 2. Shock was found in 22 (79%) cases. Average pH was 7.1 +/- 0.4 and bicarbonate concentration was 16.3 +/- 8.8 mmol/l. The ECG abnormalities were noted in 20 (72%) cases. The average mortality rate was 61%. The prognostic factors were SAPS II (P = 0.031), Apache II (p = 0.037), shock (p = 0.022), ECG abnormalities (p = 0.05), use of vasoactive drugs (p = 0.05) and use of mechanical ventilation (P = 0.003). Conclusion. - AAIPP induced a significantly high mortality and haemodynamic disturbances were a risk factor of poor outcome. (c) 2006 Elsevier SAS. Tous droits reserves.