Characteristics and outcomes of paediatric intensive care unit admissions across Kuwait: multicentre national-level cohort study.

Abstract

National paediatric intensive care registries are essential for benchmarking care, understanding population-level disease burden and identifying inter-site variation. However, such national-level data from the Middle East remains limited. This study aims to describe national patterns of paediatric intensive care unit (PICU) admissions, case mix, interventions, seasonality and outcomes across Kuwait. This retrospective multicentre cohort study included all PICU admissions across the governmental hospitals in Kuwait between 1 January 2023, and 30 June 2025. Demographic characteristics, clinical data and outcomes were extracted from a national PICU registry. Data were analysed at national and centre levels using descriptive statistics. A total of 5,534 PICU admissions were analysed. Median age was 10.5 (IQR 2.4-57) months, with infants accounting for 44.4% of admissions. Respiratory disorders were the predominant diagnosis (63.9%). The median PICU length of stay was 3 (IQR 1-6) days. The intubation rate among PICU admissions was 20.9%. Central venous access was used in 18.1% of cases. Admission peaks occurred during late autumn and winter, with a 1-month shift in peak timing in 2024 compared with that in 2023. The overall PICU mortality rate was 2.6%, with centre-level mortality ranging from 0.9% to 5.6%. Substantial inter-centre variability was observed in respiratory support practices and procedural utilisation. This study represents the first national-level analysis of PICU admissions across Kuwait. Admissions were characterised by infant predominance, a high burden of respiratory illness, short lengths of stay and low overall mortality. Marked inter-centre variability in respiratory support practices highlights opportunities for national standardisation, capacity planning and registry-driven quality improvement.