[Severity factors of aluminium phosphide poisoning (Phostoxin)].
OBJECTIVE
To determine characteristics of acute aluminum phosphide poisoning (AAlPP) and to evaluate its severity factors.


METHODS
Retrospective cohort study.


METHODS
Consecutive cases of AAlPP admitted in medical ICU (Hospital Avicenne, Rabat, Morocco) between January 1992 and December 2002 were studied. AAlPP 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).


CONCLUSIONS
AAlPP induced a significantly high mortality and haemodynamic disturbances were a risk factor of poor outcome.
Service de réanimation et de toxicologie clinique, hôpital Avicenne, Rabat, Maroc.
M
M
Hajouji Idrissi
L
L
Oualili
K
K
Abidi
R
R
Abouqal
O
O
Kerkeb
A A
AA
Zeggwagh
D018806:APACHE; D015746:Abdominal Pain / Q000139:chemically induced; D000293:Adolescent; D000328:Adult; D017607:Aluminum Compounds / Q000506:poisoning*; D002316:Cardiotonic Agents / Q000627:therapeutic use; D056486:Chemical and Drug Induced Liver Injury / Q000209:etiology; D015331:Cohort Studies; D003131:Combined Modality Therapy; D005260:Female; D005751:Gastric Lavage; D015600:Glasgow Coma Scale; D006331:Heart Diseases / Q000139:chemically induced; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D008297:Male; D009395:Nephritis, Interstitial / Q000139:chemically induced; D010720:Phosphines / Q000506:poisoning*; D011041:Poisoning / Q000401:mortality / Q000628:therapy; D011379:Prognosis; D012121:Respiration, Artificial; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012769:Shock / Q000139:chemically induced; D013406:Suicide, Attempted; D014839:Vomiting / Q000139:chemically induced
D017607:Aluminum Compounds; D002316:Cardiotonic Agents; D010720:Phosphines; C001864:aluminum phosphide