Document Type : Original Article
Authors
1 Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Zagazig University, Egypt
2 Hull University Teaching Hospitals NHS Trust, Hull, England, United Kingdom
Abstract
Background: Aluminum phosphide (AlP) is a highly toxic pesticide widely used in agricultural settings. Due to its low cost and lack of regulatory control, it has become a common cause of poisoning in Egypt, often with fatal outcomes. Early identification of prognostic markers using routine laboratory investigations may aid in improving patient outcomes.
Methods: This prospective cohort study was conducted at the Poison Control Center of Zagazig University Hospitals from January to June 2021. A total of 42 patients with confirmed AlP poisoning were enrolled. Routine laboratory parameters, including total leukocyte count (TLC), liver enzymes (AST, ALT), renal function markers (creatinine, BUN), and serum electrolytes (Na⁺, K⁺), were collected within 24 hours of admission. Patients were followed until discharge or in-hospital death. Survivors and non-survivors were compared to identify significant predictors.
Results: Serum sodium levels were significantly higher in non-survivors (P = 0.04). Potassium levels were lower overall but did not differ significantly between groups. The Total leukocyte count showed an increasing trend in non-survivors, although this trend was not statistically significant. Liver enzymes and renal function markers showed mild elevations in some cases but were not significantly associated with mortality.
Conclusion: In this prospective cohort of acute AlP poisoning, elevated serum sodium was significantly associated with in-hospital mortality, as ROC analysis for serum sodium yielded an AUC of 0.67 (0.5-0.83), while total leukocyte count showed a non-significant upward trend. These findings suggest that routine markers may offer early prognostic insight but require further validation.
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