Role of serum glucose/potassium ratio in assessing poisoning severity and adverse outcomes in patients with acute aluminum phosphide poisoning

Abstract

Aluminum phosphide (ALP) poisoning is a crucial health problem owing to its easy availability, extreme potency, and absence of specific treatment modalities. This study aimed to assess the role of the glucose/potassium (Glu-K) ratio in predicting the severity and adverse outcomes of acute ALP poisoning. The current retrospective cohort study involved patients with acute ALP poisoning who were admitted to Tanta University Poison Control Center from June 2022 to June 2024. Sociodemographic and poisoning data, initial findings of clinical examination, Glu-K ratio, and calculation of Poisoning Severity Score (PSS), Acute Physiology and Chronic Health Evaluation II (APACHE II), and PGI score were documented. Patients were categorized into two groups according to mortality outcome. Out of 206 acute ALP-poisoned patients, we recorded 67.5 % fatalities. The median value of the Glu-K ratio was significantly higher in nonsurvivors than in survivors (44.8 versus 28.9; p < 0.001). The Glu-K positively correlated with PSS, APACHE II, and PGI scores (p < 0.001). The APACHE II score exhibited the highest performance for predicting mortality and the need for mechanical ventilation (AUC=0.876 and 0.853, respectively). However, the Glu-K ratio conveyed a comparable discriminatory power with other scoring systems (PSS and PGI) for anticipating all unfavorable outcomes. Patients with a Glu-K ratio ≥ 37.07 had significantly decreased survival duration than patients with a Glu-K ratio < 37.07 (0.38 versus 3 days; p < 0.001). Therefore, the initial Glu-K ratio is an easily accessible routine biomarker for assessing poisoning severity and outcomes probability of ALP-poisoned patients, particularly with limited healthcare facilities.