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Two independent and strong predictors of mortality in patients with blunt head injury are a Glasgow Coma Scale (GCS) score of 3 and bilateral fixed and dilated pupils. These authors assessed mortality in patients with both risk factors. They reviewed the registry at a single Level 1 trauma center from 2001 through 2003 to identify blunt-head-injured patients with admission GCS scores of 3. Patients with injuries from burns, hanging, or drowning and those who were dead on arrival, legally intoxicated, or treated with paralytic agents prior to neurological assessment were excluded.
Of 173 patients who met the inclusion criteria, 104 had bilateral fixed and dilated pupils, and 69 had reactive pupils. The two groups were similar in age, Injury S…