{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T12:08:57Z","timestamp":1785326937879,"version":"3.55.0"},"reference-count":21,"publisher":"BMJ","issue":"7","license":[{"start":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:00:00Z","timestamp":1785283200000},"content-version":"unspecified","delay-in-days":28,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,7,15]]},"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 5,534 PICU admissions were analysed. Median age was 10.5 (IQR 2.4\u201357) 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\u2009(IQR 1\u20136) 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2026-119694","type":"journal-article","created":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T11:45:29Z","timestamp":1785325529000},"page":"e119694","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Characteristics and outcomes of paediatric intensive care unit admissions across Kuwait: multicentre national-level cohort study"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0179-1716","authenticated-orcid":false,"given":"Abdulla","family":"Alfraij","sequence":"first","affiliation":[{"name":"Pediatric Intensive Care Unit, Pediatrics Division, Kuwait Oil Company (KOC), Ahmadi Hospital, Al Ahmadi, Al Ahmadi Governorate, Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0665-3761","authenticated-orcid":false,"given":"Mohammad","family":"Alghounaim","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Ministry of Health, Al-Amiri Hospital, Kuwait City, Al Asimah Governate, Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mostafa","family":"Galal","sequence":"additional","affiliation":[{"name":"Pediatric Intensive Care Unit, Pediatric Department, Ministry of Health, Al Jahra Hospital, Jahra, Al Jahra Governorate, Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farahat","family":"Elsayed","sequence":"additional","affiliation":[{"name":"Pediatric Intensive Care Unit, Pediatric Department, Ministry of Health, Al Jahra Hospital, Jahra, Al Jahra Governorate, Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Abdelmoniem","sequence":"additional","affiliation":[{"name":"Pediatric Intensive Care Unit, Pediatric Department, Ministry of Health, Farwaniya Hospital, Sabah Al Nasser, Al Farwaniyah Governorate, Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ibrahim","family":"Hikal","sequence":"additional","affiliation":[{"name":"Pediatric Intensive Care Unit, Pediatric Department, Ministry of Health, Jaber Al Ahmed Al Jaber Al Sabah Hospital, South Surra area, Hawalli Governorate, Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shishir","family":"Shetty","sequence":"additional","affiliation":[{"name":"Pediatric Intensive Care Unit, Pediatric Department, Ministry of Health, Al Sabah Hospital, Sabah Health Region, Al Asimah Governorate, Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deyaa","family":"Madian","sequence":"additional","affiliation":[{"name":"Pediatric Intensive Care Unit, Pediatric Department, Ministry of Health, Mubarak Al-Kabeer Hospital, Al Jabriyah, Hawalli Governorate, Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Waleed","family":"Ramadan","sequence":"additional","affiliation":[{"name":"Pediatric Intensive Care Unit, Pediatric Department, Ministry of Health, Al Adan Hospital, Hadiyah, Al Ahmadi Governate, Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hayam","family":"Yahia","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Ministry of Health, Al-Amiri Hospital, Kuwait City, Al Asimah Governate, Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdullah","family":"Almajran","sequence":"additional","affiliation":[{"name":"Department of Community Medicine and Behavioral Sciences, Kuwait University Faculty of Medicine, Al Jaberiyah, Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0148-230X","authenticated-orcid":false,"given":"Abdulrahman","family":"AlDaithan","sequence":"additional","affiliation":[{"name":"Pediatric Intensive Care Unit, Pediatrics Division, Kuwait Oil Company (KOC), Ahmadi Hospital, Al Ahmadi, Al Ahmadi Governorate, Kuwait"},{"name":"Pediatric Intensive Care Unit, Pediatric Department, Ministry of Health, Farwaniya Hospital, Sabah Al Nasser, Al Farwaniyah Governorate, Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,7,29]]},"reference":[{"key":"2026072904452226000_16.7.e119694.1","doi-asserted-by":"crossref","DOI":"10.3389\/fped.2014.00079","article-title":"Existing data analysis in pediatric critical care research","volume":"2","author":"Bennett","year":"2014","journal-title":"Front 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From fragmentation to integration: the implementation of Kuwait\u2019s nationwide pediatric intensive care units registry. Pediatr Res 2026. doi:10.1038\/s41390-026-04775-1","DOI":"10.1038\/s41390-026-04775-1"},{"key":"2026072904452226000_16.7.e119694.6","doi-asserted-by":"crossref","first-page":"e2674","DOI":"10.1097\/CCM.0000000000006886","article-title":"Assessing Critical Care Delivery Using National-Level ICU Registry Data","volume":"53","author":"Kasotakis","year":"2025","journal-title":"Crit Care Med"},{"key":"2026072904452226000_16.7.e119694.7","unstructured":"PACI . Statistical reports-Population by gender &amp; region Kuwait. Kuwait Public Authority for Civil Information; 2026. 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