Can you survive GCS 4?

Patients with a GCS score of 4 have mortality rates of approximately 80%, with studies showing only 14.5-15% achieving good functional outcomes (Glasgow Outcome Scale 4-5) at 6 months 3, 4 Pupillary response is the factor most predictive of both survival and outcome in patients with GCS scores of 3-4 6, 3 Age significantly impacts outcomes - elderly patients (>65 years) with GCS scores of 3-4 have particularly poor prognosis, though not entirely hopeless 3 Despite the poor overall prognosis, approximately 6.9% of patients with GCS of 3 and bilateral fixed pupils on presentation to the ED can still achieve good outcomes at 6 months, suggesting that aggressive treatment should not be withheld based solely on initial GCS score 4 Withdrawing aggressive care based solely on initial GCS score of 4, as a small but significant percentage of patients can achieve good functional outcomes 4