Eizadi-Mood Nastaran, Momenzadeh Mahnaz, Sadeghi Masoumeh, Yaraghi Ahmad, Sabzghabaee Ali Mohammad, Alfred Sam
Department of Clinical Toxicology, Isfahan Clinical Toxicology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
Department of Clinical Pharmacy and Pharmacy Practice, Isfahan University of Medical Sciences, Isfahan, Iran.
J Res Pharm Pract. 2023 Nov 27;12(1):21-28. doi: 10.4103/jrpp.jrpp_20_23. eCollection 2023 Jan-Mar.
Aluminum phosphide (ALP) and zinc phosphide (ZnP) are toxic agrochemical pesticides, which are commonly used as an agent of self-harm in developing countries. Because of high toxicity of phosphides, we evaluated toxico-epidemiology ALP and ZnP poisoning in with respect to outcome.
We performed a cross-sectional study with retrospective chart review including the records for patients admitted due to phosphide poisoning (ALP, ZnP) in a poisoning referral center in Khorshid Hospital, affiliated with Isfahan University of Medial Sciences, Isfahan, Iran. Demographic characteristics, clinical manifestations, outcome (survived or death), and length of hospital stay for the patients were recorded in a data collecting form. Binary backward stepwise logistic regression was used for outcome prediction.
Sixty patients were evaluated in the study. The mean age of patients was 27.61. Thirty-nine patients were men. 96.7% of the patients ingested it intentionally. Most of the patients on admission were conscious (66.7%). Abnormality of EKG was noted in 8.3%. The mortality in ALP and ZnP poisoning was 39.2% and 22.2%, respectively. Serum bicarbonate and base excess in the venous blood gas analysis, systolic blood pressure, and serum sodium level were significantly different between patients with ALP and ZnP poisoning on admission time ( < 0.05). On admission, systolic blood pressure was an important predictive factor for mortality (odds ratio 4.87; 95% confidence interval: 1.5-15.45; = 0.007).
The rate of mortality in phosphide poisoning is high. Knowing predictive factors for mortality help physicians for selecting patients in intensive care unit admission and aggressive treatment.
磷化铝（ALP）和磷化锌（ZnP）是有毒的农用化学杀虫剂，在发展中国家常被用作自杀手段。由于磷化物毒性高，我们对ALP和ZnP中毒的毒理流行病学结局进行了评估。
我们进行了一项横断面研究，并回顾性查阅病历，研究对象为伊朗伊斯法罕医科大学附属霍什德医院中毒转诊中心收治的因磷化物中毒（ALP、ZnP）的患者记录。患者的人口统计学特征、临床表现、结局（存活或死亡）以及住院时间被记录在一份数据收集表中。采用二元向后逐步逻辑回归进行结局预测。
本研究共评估了60例患者。患者的平均年龄为27.61岁。39例为男性。96.7%的患者是故意摄入的。大多数患者入院时意识清醒（66.7%）。8.3%的患者心电图异常。ALP和ZnP中毒的死亡率分别为39.2%和22.2%。入院时，ALP和ZnP中毒患者的静脉血气分析中的血清碳酸氢盐和碱剩余、收缩压以及血清钠水平存在显著差异（P<0.05）。入院时，收缩压是死亡率的一个重要预测因素（比值比4.87；95%置信区间：1.5 - 15.45；P = 0.007）。
磷化物中毒的死亡率很高。了解死亡率的预测因素有助于医生选择入住重症监护病房的患者并进行积极治疗。
