Aluminum Phosphide Poisoning: An Observational Study from a Tertiary Care Center in North Karnataka

Background: Aluminum phosphide (AlP) is a cheap and easily accessible pesticide widely used in India, often implicated in deliberate self-harm. Upon ingestion, it releases phosphine gas, which causes mitochondrial dysfunction, multiorgan failure, and high mortality. This study aims to evaluate the clinical profile, complications, outcomes, and predictors of mortality among patients with aluminum phosphide poisoning. Materials and Methods: This retrospective observational study was conducted at a tertiary care center in North Karnataka from January 2022 to December 2024. All patients with confirmed ingestion of AlP were included in the study. Clinical features, complications, hospital course, and outcomes were recorded. Statistical analysis included descriptive statistics, Chi-square tests, and multivariate logistic regression. P <0.05 was considered significant. Results: A total of 71 patients were studied, with a mean age of 29.18 years. Males accounted for 69.01% of cases. The most common presenting symptoms were vomiting (78.87%), breathlessness (38.03%), and altered sensorium (33.80%). Bradycardia (43.66%) and hypotension (45.07%) were the most frequently observed conditions. Major complications included myocarditis (38.02%), hepatitis (11.26%), acute kidney injury (18.30%), and acute respiratory distress syndrome (ARDS) (11.26%). The overall mortality rate was 35.21%. Myocarditis was significantly associated with increased mortality (odds ratios [OR] 14.2, P < 0.00001), followed by ARDS (OR 2.8, P = 0.02), and delayed presentation (>6 h) (OR 3.9, P = 0.001). Conclusions: AlP poisoning continues to result in high morbidity and mortality. Myocarditis is a strong predictor of poor outcomes. Prompt recognition and aggressive supportive management are crucial for improving survival in individuals affected by this condition.