Indian Journal of Critical Care Medicine

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VOLUME 24 , ISSUE 9 ( September, 2020 ) > List of Articles

Original Article

“PGI Score”: A Simplified Three-point Prognostic Score for Acute Aluminum Phosphide Poisoning

Arvind Sharma

Keywords : Aluminum phosphide, Case-fatality rate, Grain fumigants, Mortality, Pesticide poisoning, Prognostic tool, Scoring system, Severity

Citation Information : Sharma A. “PGI Score”: A Simplified Three-point Prognostic Score for Acute Aluminum Phosphide Poisoning. Indian J Crit Care Med 2020; 24 (9):790-793.

DOI: 10.5005/jp-journals-10071-23555

License: CC BY-NC 4.0

Published Online: 17-10-2020

Copyright Statement:  Copyright © 2020; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Introduction: Aluminum phosphide (AlP) ingestion for self-harm is associated with a high case-fatality rate (CFR) in low- and middle-income countries. A reliable and accurate prognostic scoring tool is required for appropriate triaging, to guide clinical decision-making, and to evaluate the efficacy of therapeutic interventions for the patients with AlP toxicity. Materials and methods: We performed a prospective cohort study in a tertiary care hospital in north India in patients aged 15 years and over with acute AlP poisoning, investigating the parameters associated with CFR, and developing a reliable and simple prediction score. Results: The CFR was 51% in this cohort of 105 patients. Three parameters—pH <7.25, score on Glasgow coma scale (GCS) <13, and systolic blood pressure (SBP) <87 mm Hg were most robust predictors of CFR (odds ratio; 12.614, 18.621, and 17.600, respectively; area under the receiver operating characteristic curve—0.808, 0.796, and 0.776, respectively). Based on these parameters (with 1 point to each), a prognostic score was developed, ranging from 0 to 3 points. A total score of 3 had a 98.2% specificity and a positive predictive value of 96.4%, whereas a score ≤1 had a 100% sensitivity and 100% negative predictive value. Conclusion: A scoring system based on low pH (P), low GCS score (G), and impaired or low SBP (I) (“PGI” score) may provide a simplified predictive model for mortality in AlP poisoning.


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