Background: Aluminium phosphide poisoning epitomizes a critical medical emergency that is commonly encountered in the Middle East, especially in Egypt. Prompt early assessment is essential to guide the most effective and intensive treatment strategies. Despite the establishment of various scoring systems to predict outcomes in ALP poisoned cases, these scoring systems have been criticized due to their complexity and reliability. In light of this, the current study was conducted to assess the value of the newly proposed PGI score based on three parameters: low pH (P), low GCS(G) and impaired or low blood pressure (I).

Patients and Methods: A prospective observational study was conducted from the beginning of October 2023 to the end of March 2024 on patients with acute aluminium phosphide poisoning who were admitted to the Poison Control Centre at Ain Shams University Hospitals (PCC ASUH). Sociodemographic, intoxication and clinical data were collected for every patient. Investigations done on admission included arterial blood gas analysis, random blood sugar, serum electrolytes, liver enzymes, creatinine and complete blood count (CBC), as well as an electrocardiogram (ECG). Outcome was recorded.

Results: Among 45 included patients of both sexes with acute ALP poisoning, we reported a mortality rate of 60%. Non-survivors exhibited significantly higher PGI score than survivors. PGI score showed an excellent area under the curve (AUC = 0.998). In addition, PGI of 0 or more was a significant predictor of mortality with 100% sensitivity and 94.4 % specificity.

Conclusion: PGI score is a recommended predictor of mortality in ALP-poisoned patients.