Aluminum Phosphide Poisoning Mortality Rate in Iran; aSystematic Review and Meta-Analysis

According to statistics provided by the forensic medicine facility of Iran, there are a high num-ber of Aluminum phosphide (ALP) poisoning-related deaths in the country; while the mortality rate varies indifferent studies. This study aimed to determine a pooled estimate of ALP poisoning mortality rate in Iran.

The present study was a systematic review and meta-analysis of the mortality rate of ALP poisoningin Iran. Through the quarry of Persian and English databases, using “aluminum phosphide”, “phosphine”, “ricepills”, “poisoning”, and “Iran” as keywords, and no time restrictions, studies reporting mortality rate in ALP poi-soning cases were collected. The random-effects model was used to pool the proportions of mortality and ageof survivors versus non-survivors.

21 studies with 3432 cases of ALP poisoning were included in thismeta-analysis. The pooled mortality rate of ALP poisoning in Iran was 39.6%, (95% CI: 31.5%-47.9%; I2 = 95%).Since there was significant publication bias, the trim-and-fill correction was conducted and the corrected pooledmortality rate was estimated to be 27.3% (95% CI: 18.9%- 36.5%), which is the rate that should be considered forclinical guidance. Morality rate in male and female patients was 62.3% (95% CI: 53.5%-70.8%) and 37.7% (95%CI: 29.2%-46.5%), respectively (p < 0.01). Survivors had significantly lower mean age than non-survivors (SMD:-0.26 (95% CI: -0.37 to -0.15); p < 0.01; I2=0%).

According to this report, the Mortality rate of ALPpoisoning in Iranian population is about 27%, with men having a higher fatality rate than women. Poisoning ata younger age is associated with better results.