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Browsing School of Medicine by Author "Fitsum Mola"

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    Assessment of clinical profile, treatment outcome, and associated factors among aluminum phosphide poisoning patients at Asella referral and teaching hospital, Arsi university
    (2025-05-01) Fitsum Mola
    ABSTRACT Background: Aluminum phosphide (AlP) is an economical, widely utilized rodenticide and solid fumigant associated with an exceptionally high case fatality rate. In Ethiopia, AlP poisoning has emerged as a significant public health issue, marked by elevated mortality and a lack of extensive local research. Because no specific antidote exists, identifying clinical predictors is essential for improving survival through optimized supportive care. Objective: To assess the clinical profile, treatment outcomes, and associated factors among aluminum phosphide poisoning patients presented to the adult emergency department of Asella Referral and Teaching Hospital (ARTH), central Ethiopia. Methods: An institution-based cross-sectional study was conducted analyzing 116 eligible cases presented between August 2020 and 2025. All eligible AlP poisoning cases were included to maximize statistical power. Data were extracted from medical registries using a structured tool and analyzed via SPSS version 26. Descriptive statistics will be conducted to characterize the study population. Bivariate and multivariable logistic regression models were employed to identify independent predictors of mortality, with statistical significance set at p < 0.05. Results: Among the 116 cases, the majority were female (58.8%), rural residents (79.3%), and young adults with a mean age of 26 years. All instances (100%) were identified as intentional self-harm. The most common clinical manifestations were vomiting (100%), epigastric pain (93%), and initial hypotension (40.5%). Despite medical management, including the use of magnesium sulfate and calcium gluconate in nearly half of the cases, the overall mortality rate was 31%. Multivariable analysis identified two independent predictors of the mortality: initial hypotension (SBP ≤ 90 mmHg) (AOR = 264.946; 95% CI: 1.175, 5.9x10⁴, p = 0.044), and a hospital stay of less than two days (AOR = 167.269; 95% CI: 4.282, 6534.394, p = 0.006). Conclusion: Aluminum phosphide poisoning remains a highly lethal method of self-harm. Hemodynamic instability and a hospital stay of less than two days—serve as the primary determinant of mortality. These findings underscore the need for rapid hemodynamic support. Keywords: Aluminum phosphide, Clinical profile, Mortality, Associated factors, Ethiopia