Acute Kidney Injury as an Independent Predictor of In-Hospital Mortality in a General Medical Ward: A Prospective Observational Study from a Tertiary Care Centre in India

Abstract

Background: Acute kidney injury (AKI) frequently occurs among hospitalized patients and is strongly linked with adverse clinical outcomes, including increased morbidity and mortality. Despite growing recognition of its impact, prospective evidence from general medical wards in India remains limited.

Objective: To evaluate whether AKI independently predicts in-hospital mortality among patients admitted to a general medical ward.

Methods: A prospective observational study was conducted at PMCH, Patna, between April 2025 and December 2025. Ninety adult patients admitted to the general medical ward were included. AKI was identified and categorized according to KDIGO criteria. Clinical characteristics and outcomes were documented systematically. Logistic regression analysis was performed to determine independent predictors of in-hospital mortality.

Results: AKI occurred in 31 patients (34.4%). Mortality during hospitalization was significantly higher in patients with AKI (38.7%) compared with those without AKI (8.5%) (p<0.001). A progressive rise in mortality was observed with increasing AKI stage (p<0.001). Multivariate analysis demonstrated that AKI independently predicted in-hospital death (Adjusted OR 4.92; 95% CI 1.62–14.89; p=0.005).

Conclusion: AKI independently increases the risk of in-hospital mortality among patients admitted to a general medical ward. Timely detection and appropriate management strategies may help improve clinical outcomes.

Keywords: Acute kidney injury, mortality, KDIGO, medical ward, India