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A study of the predictive factors of mortality in acute poisoning with aluminum phosphide with special reference to echocardiography and SOFA score

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Abstract

Aluminum phosphide (AlP) is considered now one of the most common causes of poisoning among agricultural pesticides. Poisoning with AlP is extremely toxic to humans with high mortality rate. The aim of this work was to evaluate the prognostic factors and outcome of acute aluminum phosphide poisoning in Alexandria Main University Hospital during a period of 6 months from 1 November 2017 until the end of April 2018, highlighting the role of SOFA score and echocardiography in predicting the mortality. The prospective study was conducted on all patients admitted with acute AlP poisoning to Alexandria Main University Hospital for those 6 months. Patients’ data were collected in a special sheet and included biosocial data, medical history, poisoning history, complete medical examination, investigations, duration of hospital stay, and the outcome. All patients were assessed according to SOFA score on admission. Thirty patients were admitted during the period of the current study. Females outnumbered males in all age groups with a sex ratio of 2.75:1. The mean age of patients was 22.77 ± 12.79 years. 96.6% of patients came from rural areas. 93.3% of the cases were exposed to poisoning at home, where suicidal poisoning accounted for (86.7%) of cases. 43.3% of patients died (n = 13), and the median value of SOFA score among non-survivors was 10, versus 1 among survivors. The median value of ejection fraction among non-survivors (25%) was half its value in survivors (50%). Although there were many predictors of severity of AlP poisoning, SOFA score was the most predictive factor of mortality detected by multivariate analysis.

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Authors and Affiliations

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

    Abeer A. Sheta, Asmaa S. El-Banna, Rania Abd Elmeguid & Nehad H. Gad

  2. Department of Critical Care Medicine, Faculty of Medicine, Alexandria University, Alexandria, Egypt

    Hany E. Mohamed

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  1. Abeer A. Sheta
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  2. Asmaa S. El-Banna
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  3. Rania Abd Elmeguid
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  4. Hany E. Mohamed
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  5. Nehad H. Gad
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Correspondence to Asmaa S. El-Banna.

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Informed consent was obtained from all participants included in the study or from their relatives in case of comatose patients, explaining the aim and the procedure of the study. Complete confidentiality was ensured all throughout the study procedure. The study protocol was approved by the ethical committee of Alexandria Faculty of Medicine.

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Sheta, A.A., El-Banna, A.S., Elmeguid, R.A. et al. A study of the predictive factors of mortality in acute poisoning with aluminum phosphide with special reference to echocardiography and SOFA score. Environ Sci Pollut Res 26, 33135–33145 (2019). https://doi.org/10.1007/s11356-019-06457-4

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