A hemorragia intracerebral (AVCH) espontânea ainda apresenta grande heterogeneidade em sua avaliação clínica, evidenciando diferenças nos critérios de inclusão utilizados nos estudos de tratamento da hemorragia intracerebral (ICH). O objetivo do presente estudo foi avaliar o ICH Score, uma escala simples e confiável, determinando a mortalidade em 30 dias e o resultado funcional após um ano. Pacientes consecutivos com AVCH espontâneo foram incluídos prospectivamente no estudo. O ICH Score variou de 0 a 4 e cada aumento no ICH Score esteve associado com um aumento na mortalidade em 30 dias e com uma progressiva diminuição nas taxas de bom resultado funcional. Entretanto, a ocorrência de injúria da via piramidal esteve melhor relacionada com um pior resultado funcional do que o ICH Score. O ICH Score é um bom preditor de mortalidade em 30 dias e resultado funcional, confirmando sua validade em diferentes populações socioeconômicas. A associação da injúria da via piramidal como variável auxiliar fornece informações mais precisas sobre a evolução prognóstica.

Spontaneous intracerebral hemorrhage (SICH) still presents a great heterogeneity in its clinical evaluation, demonstrating differences in the enrollment criteria used for the study of intracerebral hemorrhage (ICH) treatment. The aim of the current study was to assess the ICH Score, a simple and reliable scale, determining the 30-day mortality and the one-year functional outcome. Consecutive patients admitted with acute SICH were prospectively included in the study. ICH Scores ranged from 0 to 4, and each increase in the ICH Score was associated with an increase in the 30-day mortality and with a progressive decrease in good functional outcome rates. However, the occurrence of a pyramidal pathway injury was better related to worse functional outcome than the ICH Score. The ICH Score is a good predictor of 30-day mortality and functional outcome, confirming its validity in a different socioeconomic populations. The association of the pyramidal pathway injury as an auxiliary variable provides more accurate information about the prognostic evolution.

Ventilator-associated pneumonia (VAP) is the most commonly-acquired infection in patients in intensive care units. We analyzed epidemiological and microbiological characteristics and the outcome, in a cohort of critically-ill patients with confirmed diagnosis of VAP. All patients who had been on mechanical ventilation (MV) for more than 48 hours were included in our study; material collection for microbiological analysis was done within the first 24 hours after beginning treatment or after changing antibiotics. There were 55/265 (20.7%) VAP cases diagnosed, at a rate of 21.6 episodes per 1,000 days of mechanical ventilation. Mean age of the patients was 66 years, with a mean APACHE II score of 26.7 + 7.0; male patients were more prevalent. The mortality rates in the intensive care unit (ICU) and during the hospital stay were 71% and 80%, respectively. MV duration in patients with VAP was 17 (range 3-43) days and among patients who had not developed VAP, 6 (2-32) days (p < 0.0001). 98.2% of the samples were positive, with a high prevalence of Gram-negative bacteria, mainly Acinetobacter calcoaceticus. Risk factors for death included age, MV duration and surgery. VAP incidence in this sample of critically-ill patients was high, with a high mortality rate. Control and prevention strategies based on continuing education of healthcare workers, developed by a multidisciplinary team, should be encouraged to minimize morbimortality of this infection.