Metabolic Acidosis: Determinant of Hospital Mortality of Patients with Aluminum Phosphide Poisoning

Background: Rice Tablet, with the scientific chemical name of aluminum phosphide (ALP), is the most common pesticides and insecticides agent in agriculture, horticulture and is used to protect beans, cereals, and rice. Poisoning with this tablet is associated with a high mortality rate. The aim of this study was to evaluate patients who committed suicide with rice tablets and referred to Sina Hospital, Tabriz, during the years 2011-2015. Methods: In a routine data base study that was conducted at Sina Hospital affiliated to Tabriz University of Medical Sciences, medical records of patients with suicide attempt with rice tablets during the years 2011-2015 were evaluated. During the mentioned period, 90 patients with rice tablet poisoning were admitted to the hospital. The required information was recorded in the check list. Results: Out of 90 patients, 72 patients (80%) had ALP tablets poisoning. The mean age of subjects was 27.52±0.13 years. In patients with ALP poisoning, the mean of mean arterial pressure (MAP), serum pH, serum bicarbonate, and arterial oxygen saturation between two groups (with or without mortality) were statistically significant (P value˂0.001). All variables are related to admission time in the emergency department. To determine the prognostic value of these variables in predicting mortality in patients with ALP poisoning logistic regression was used and only serum bicarbonate can predict mortality with P value=0.011. Conclusion: The results of the current study show that the survival of patients with ALP poisoning is associated with MAP, pH, and serum HCo3, arterial blood oxygen saturation at the time of admission in the emergency department. Next prospective studies are recommended for more accurate evaluation of the effect of these variables on the patients' survival.