Zaghary Meray Medhat Shokry, Ali Hasnaa Ahmed Ahmed, Ahmed Asmaa Mohammed Khalaf
Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Sohag University, Sohag 82524, Egypt.
Toxicol Res (Camb). 2025 Jan 8;14(1):tfae232. doi: 10.1093/toxres/tfae232. eCollection 2025 Jan.
Aluminium phosphide poison become an alarming, well-known, effective suicidal poison with a high mortality rate. There is a need for a simple tool that can triage patients with bad prognosis. The study aimed to assess the accuracy of ejection fraction as a predictor of mortality and morbidity in acute aluminium phosphide toxicity cases. The study involved 70 cases of acutely aluminium phosphide-poisoned patients in our hospital from January 2021 to January 2024. The study found that 54.3% of the cases were males and 45.7% were females, with a mean age of 22.4 ± 11.8 years old. The oral route was the route of administration of all cases, and the intention of poisoning was intentional in 84.3% of cases. Regarding the outcome of patients, 62.9% of the cases recovered, and 37.1% died. The Receiver Operating Characteristic Curve found that the ejection fraction below 37.5% had an accuracy rate of 96.8% with excellent discrimination for mortality, sensitivity of 100%, specificity of 93.2%, positive predictive value of 89.6%, and negative predictive value of 100%. The ejection fraction below 52.5% had an accuracy rate of 89% with good discrimination for complications, sensitivity of 83.3%, specificity of 96.8%, positive predictive value of 90.9%, and negative predictive value of 93.7%. So, the ejection fraction plays an essential tool in predicting mortality and complications in acute aluminium phosphide toxicity and should be assessed on every patient in the first 24 h of admission to facilitate the triage of these patients.
磷化铝中毒已成为一种令人担忧、广为人知且有效的自杀性毒物,死亡率很高。需要一种简单的工具来对预后不良的患者进行分诊。本研究旨在评估射血分数作为急性磷化铝中毒病例死亡率和发病率预测指标的准确性。该研究纳入了2021年1月至2024年1月我院收治的70例急性磷化铝中毒患者。研究发现,54.3%的病例为男性,45.7%为女性,平均年龄为22.4±11.8岁。所有病例的给药途径均为口服,84.3%的病例中毒意图为故意。关于患者的结局,62.9%的病例康复,37.1%死亡。受试者工作特征曲线发现,射血分数低于37.5%时,准确率为96.8%,对死亡率具有出色的区分能力,敏感性为100%,特异性为93.2%,阳性预测值为89.6%,阴性预测值为100%。射血分数低于52.5%时,准确率为89%,对并发症具有良好的区分能力,敏感性为83.3%,特异性为96.8%,阳性预测值为90.9%,阴性预测值为93.7%。因此,射血分数在预测急性磷化铝中毒的死亡率和并发症方面起着重要作用,应在入院后24小时内对每位患者进行评估,以促进对这些患者的分诊。