title: Plain abdominal radiography: a powerful tool to prognosticate outcome in patients with zinc phosphide poisoning.
abstract: OBJECTIVE
  To evaluate the clinical features of zinc phosphide poisoning and to investigate whether outcome could be prognosticated based on abdominal radiography on presentation.
  
  
  METHODS
  All zinc phosphide-poisoned patients who were referred to Loghman-Hakim Hospital between March 2011 and September 2013 were retrospectively reviewed. Data regarding patients' demographic characteristics, characteristics of the poisoning, abdominal radiography results, and patients' outcome were recorded.
  
  
  RESULTS
  In 102 patients, the most common presenting signs/symptoms were nausea and vomiting (60%). Four patients died and another seven had developed complications during their hospitalization (metabolic acidosis, liver abnormalities, or acute renal failure). Nineteen patients had radio-opaque abdominal radiographs, nine of whom had died or developed complications (p = 0.001). Plain abdominal radiography had a sensitivity and specificity of 81% and 89% in predicting the patients' death or further development of complications. The positive and negative predictive values were 47% and 97%, respectively.
  
  
  CONCLUSIONS
  Plain abdominal radiography is a very good tool for prognostication in patients with zinc phosphide poisoning. Immediate abdominal radiography can help stratify patients into high- or low-risk groups and determine treatment strategies.
authors.affiliation: Department of Clinical Toxicology, Loghman-Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: H
authors.initials: H
authors.lastname: Hassanian-Moghaddam
authors.affiliation: Department of Radiology, Loghman-Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Makhtoom
authors.initials: M
authors.lastname: Shahnazi
authors.affiliation: Department of Clinical Toxicology, Loghman-Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Electronic address: nasim.zamani@gmail.com.
authors.forename: N
authors.initials: N
authors.lastname: Zamani
authors.affiliation: Department of Clinical Toxicology, Loghman-Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: M
authors.initials: M
authors.lastname: Rahimi
authors.affiliation: Department of Radiology, Loghman-Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: H
authors.initials: H
authors.lastname: Bahrami-Motlagh
authors.affiliation: Department of Clinical Toxicology, Loghman-Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: H
authors.initials: H
authors.lastname: Amiri
mesh_terms: D000138:Acidosis / Q000139:chemically induced / Q000401:mortality; D058186:Acute Kidney Injury / Q000139:chemically induced / Q000401:mortality; D000293:Adolescent; D000328:Adult; D000368:Aged; D056486:Chemical and Drug Induced Liver Injury / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010720:Phosphines / Q000506:poisoning*; D011041:Poisoning / Q000150:complications / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D011379:Prognosis; D011860:Radiography, Abdominal / Q000379:methods*; D012189:Retrospective Studies; D012378:Rodenticides / Q000506:poisoning*; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D055815:Young Adult; D017967:Zinc Compounds / Q000506:poisoning*
chemical_list: D010720:Phosphines; D012378:Rodenticides; D017967:Zinc Compounds; C009701:zinc phosphide