Bagherian Farhad, Kalani Navid, Rahmanian Fatemeh, Abiri Samaneh, Hatami Naser, Foroughian Mahdi, Mehramiz Neema John, Shahi Behzad
Department of Emergency Medicine, Babol University of Medical Sciences, Babol, Iran.
Research center for social Determinants of Health, Jahrom University of Medical Sciences, Jahrom, Iran.
Arch Acad Emerg Med. 2021 Oct 3;9(1):e66. doi: 10.22037/aaem.v9i1.1396. eCollection 2021.
According to statistics provided by the forensic medicine facility of Iran, there are a high number of Aluminum phosphide (ALP) poisoning-related deaths in the country; while the mortality rate varies in different studies. This study aimed to determine a pooled estimate of ALP poisoning mortality rate in Iran.
The present study was a systematic review and meta-analysis of the mortality rate of ALP poisoning in Iran. Through the quarry of Persian and English databases, using "aluminum phosphide", "phosphine", "rice pills", "poisoning", and "Iran" as keywords, and no time restrictions, studies reporting mortality rate in ALP poisoning cases were collected. The random-effects model was used to pool the proportions of mortality and age of survivors versus non-survivors.
21 studies with 3432 cases of ALP poisoning were included in this meta-analysis. The pooled mortality rate of ALP poisoning in Iran was 39.6%, (95% CI: 31.5%-47.9%; I = 95%). Since there was significant publication bias, the trim-and-fill correction was conducted and the corrected pooled mortality rate was estimated to be 27.3% (95% CI: 18.9%- 36.5%), which is the rate that should be considered for clinical guidance. Morality rate in male and female patients was 62.3% (95% CI: 53.5%-70.8%) and 37.7% (95% CI: 29.2%-46.5%), respectively (p < 0.01). Survivors had significantly lower mean age than non-survivors (SMD: -0.26 (95% CI: -0.37 to -0.15); p < 0.01; I=0%).
According to this report, the Mortality rate of ALP poisoning in Iranian population is about 27%, with men having a higher fatality rate than women. Poisoning at a younger age is associated with better results.
根据伊朗法医学机构提供的统计数据，该国因磷化铝（ALP）中毒导致的死亡人数众多；而不同研究中的死亡率有所差异。本研究旨在确定伊朗ALP中毒死亡率的合并估计值。
本研究是对伊朗ALP中毒死亡率的系统评价和荟萃分析。通过在波斯语和英语数据库中检索，以“磷化铝”“磷化氢”“米药”“中毒”和“伊朗”作为关键词，且无时间限制，收集报告ALP中毒病例死亡率的研究。采用随机效应模型汇总死亡率以及幸存者与非幸存者的年龄比例。
本荟萃分析纳入了21项研究，共3432例ALP中毒病例。伊朗ALP中毒的合并死亡率为39.6%，（95%置信区间：31.5%-47.9%；I² = 95%）。由于存在显著的发表偏倚，进行了剪补法校正，校正后的合并死亡率估计为27.3%（95%置信区间：18.9%-36.5%），这是临床指导应考虑的比率。男性和女性患者的死亡率分别为62.3%（95%置信区间：53.5%-70.8%）和37.7%（95%置信区间：29.2%-46.5%）（p<0.01）。幸存者的平均年龄显著低于非幸存者（标准化均数差：-0.26（95%置信区间：-0.37至-0.15）；p<0.01；I²=0%）。
根据本报告，伊朗人群中ALP中毒的死亡率约为27%，男性的死亡率高于女性。年龄较小的中毒者预后较好。
