PREDICTIVE VARIABLES OF ACUTE ALUMINUM PHOSPHIDE POISONING OUTCOME: A NEW PROPOSED MODEL

Abstract

Introduction: Acute aluminum phosphide (AlP) poisoning is a major toxicological challenge in developing countries especially in absence of specific antidote. Aim of the study: The current study aimed to identify predictive variables of outcome in acute AlP poisoning, then propose and validate a prediction model. Patients and Methods: This study was conducted on patients with acute AlP poisoning admitted at Tanta Poison Control Center from January 2018 to December 2018 (derivation group) and from January 2019 to June 2019 (validation group). For each patient, age, sex and toxicological characteristics were obtained. Clinical examination, routine laboratory investigations, central venous pressure measurement and electrocardiography were also done. Results: Data of the derivation group (110 patients) revealed that, systolic blood pressure, central venous pressure, pH and prothrombin time were significant predictive variables. Using univariate and multivariate regression analysis, systolic blood pressure, central venous pressure and pH were valid to construct the prediction model at cut off ≤85 mmHg, >22 cmH2O and ≤7.33 respectively. Variables were given points and the maximum sum points were 10. The power of the proposed model to discriminate between survivors and non-survivors at cut off ≥4 and ≥5 sum points was excellent (AUC: 0.974). The discrimination power in the validation group (58 patients) was excellent (AUC: 0.917). Conclusion: This proposed model could be considered a simple and excellent tool to predict acute aluminum phosphide poisoning outcome.