BACKGROUND:
Intensive care units (ICU) are crucial for managing critically ill children, with King Faisal Hospital (KFH) in Kigali playing a key role in Rwanda's healthcare landscape. This study aims to describe the demographic characteristics, primary diagnoses, length of stay, predictors of mortality and mortality rates among pediatric patients admitted to the ICU.

METHODS:
We conducted a 5-year retrospective study at KFH from June 2019 until June 2024. We used a full coverage sampling technique. We collected a total of 274 pediatric patients paper based register records. We recorded the demographics, admission details, ICU care and outcomes of pediatric patients in the ICU. We then analyzed ICU patient data using descriptive statistics and cross tabulation to examine baseline characteristics, gender, length of stay, and reasons for admission. Stepwise logistic regression identified factors associated with higher mortality risk.

RESULTS:
A total of 274 children were admitted to the ICU at KFH over the study period. The predominant age group was 1 to 3 years. The mean length of stay was 8.93 days. The longest stay was 185 days. Respiratory diseases were responsible for the largest number of pediatric patients in the ICU. The most common respiratory causes for admission were respiratory failure (14.65%), pneumonia (9.89%) and bronchiolitis (3.3%). There was a strong association between mechanical ventilation and morality rate, this effect is statistically significant with a p-value of .0001. The mortality rate was 20.8 %.

CONCLUSIONS:
This study highlights the significant burden of respiratory illnesses among pediatric ICU admissions at King Faisal Hospital, with children under three years being the most affected. Mechanical ventilation was a strong, independent predictor of mortality, emphasizing the severity of cases requiring this intervention. The overall mortality rate of 20.8% reflects challenges typical of resource-limited settings.