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Prognostic factors of acute aluminum phosphide poisoning.
Indian J Med Sci ; 2009 June; 63(6) 227-234
Artículo en Inglés | IMSEAR | ID: sea-145412
ABSTRACT

Background:

In Morocco, acute aluminum phosphide poisoning (AAlPP) is a serious health care problem. It results in high mortality rate despite the progress of critical care.

Aims:

The present paper aims at determining the characteristics of AAlPP and evaluating its severity factors. Setting and

design:

We studied consecutive patients of AAlPP admitted to the medical intensive care unit (ICU) (Ibn Sina Hospital, Rabat, Morocco) between January 1992 and December 2007. Materials and

Methods:

Around 50 parameters were collected, and a comparison was made between survivor and nonsurvivor groups. Statistical

Analysis:

Data were analyzed using Fisher exact test, Mann-Whitney U test and Cox regression model.

Results:

Forty-nine patients were enrolled 31 females and 18 males; their average age was 26± 11 years. The ingested dose of aluminum phosphide was 1.2± 0.7 g. Self-poisoning was observed in 47 cases, and the median of delay before admission to the hospital was 5.3 hours (range, 2.9-10 hours). Glasgow coma scale was 14± 2. Shock was reported in 42.6% of the patients. pH was 7.1± 0.4, and bicarbonate concentration was 16.3± 8.8 mmol/L. Electrocardiogram abnormalities were noted in 28 (57%) cases. The mortality rate was 49% (24 cases). The prognostic factors were APACHE II (P= 0.01), low Glasgow coma scale (P= 0.022), shock (P= 0.0003), electrocardiogram abnormalities (P= 0.015), acute renal failure (P= 0.026), low prothrombin rate (P= 0.020), hyperleukocytosis (P= 0.004), use of vasoactive drugs (P< 0.001), use of mechanical ventilation (P= 0.003). Multivariate analysis by logistic regression revealed that mortality in AAlPP correlated with shock (RR = 3.82; 95% CI= 1.12-13.38; P= 0.036) and altered consciousness (RR= 3.26; 95% CI= 1.18-8.99; P= 0.022).

Conclusion:

AAlPP is responsible for a high mortality, which is primarily due to hemodynamic failure.
Asunto(s)

Texto completo: Disponible Índice: IMSEAR (Asia Sudoriental) Asunto principal: Plaguicidas / Fosfinas / Intoxicación / Pronóstico / Femenino / Humanos / Masculino / Enfermedad Aguda / Adolescente / Compuestos de Aluminio Tipo de estudio: Estudio pronóstico País/Región como asunto: Africa Idioma: Inglés Revista: Indian J Med Sci Año: 2009 Tipo del documento: Artículo

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Texto completo: Disponible Índice: IMSEAR (Asia Sudoriental) Asunto principal: Plaguicidas / Fosfinas / Intoxicación / Pronóstico / Femenino / Humanos / Masculino / Enfermedad Aguda / Adolescente / Compuestos de Aluminio Tipo de estudio: Estudio pronóstico País/Región como asunto: Africa Idioma: Inglés Revista: Indian J Med Sci Año: 2009 Tipo del documento: Artículo