1Emergency Medicine, Amrita institute of Medical Sciences & Research Center, Ponnekkara, Ernakulam-683542
2General Medicine, Amrita institute of Medical Sciences & Research Center, Ponnekkara, Ernakulam-683542
*(Author of Correspondence): E-mail: dr.sbharathprasad@gmail.com
Online published on 16 February, 2018.
To predict the clinical & demographic profile of patients who presented to a tertiary centre in southern India with zinc Phosphide poisoning.
A retrospective crosssectional analysis of all acute zinc phosphide poisoning cases who presented to our emergency medicine department within January 1st 2010 to June 30th 2015 was done.
The average age of the cases was 23.6 years. 53.34% were female and 35.55% of total cases were married. Out of 45, 88.88% took the product in an attempt of suicide and the rest 11.11% ingested it accidentally. Of the 40 suicide attempts, 15.5% had previous history for suicide attempts. All patients had nausea & vomiting as initial symptoms, while 60% had breathlessness & 48.88% had abdominal pain too. All patients had tachycardia as a common sign while 75% cases also had tachypnea. 75% patients developed bleeding manifestations & 53.33% had encephalopathy during the course. 64.4% had hypotension needing inotropic support. Renal failure was seen in 48.8% cases. Within 72hours 60% of cases had high anion gap non-compensated metabolic acidosis. Of the 33.33% subjects who had an elevation of SGOT/SGPT within 24hrs of ingestion, 53.33% died while 46.67% required liver transplantation.
Although it is a rare form of suicide attempt, the mortality rate (46.66%) we got was high. In most patients alteration of SGOT/SGPT values was apparent only after 72hrs of ingestion & mortality is high in those who showed an elevation within 24hrs. Patients developing severe hepatic failure, increased INR, hypotension, encephalopathy and metabolic acidosis had high mortality rate.
Suicide attempt, zinc phosphide, poisoning, emergency department, fulminant hepatic failure
