Eye (1-4) + Verbal (1-5) + Motor (1-6) baseline total.
Photoreaction Audit
Neuro-Sentinel Anchor
The GCS-P (GCS Minus Pupils) is a high-authority prognostic tool that provides more granular risk stratification than GCS alone in TBI contexts.
Neurological Sentinel Probe
Input the baseline GCS and Pupil Reactivity status to calculate the integrated GCS-P score for advanced TBI prognosis.
Guidelines & Evidence
Clinical Details
Section 1
When to Use
When to Use
Acute assessment of traumatic brain injury (TBI).
Predicting 6-month mortality and functional outcome.
Identifying which patients with a floor GCS (3) still have a chance for meaningful recovery.
Section 2
Formula & Logic
Formula
GCS-P = GCS Total Score − Pupil Reactivity Score (PRS)
PRS Calculation:
0 = Both pupils reactive
1 = One pupil unreactive
2 = Both pupils unreactive
GCS-P Range: 1 to 15
Section 3
Pearls/Pitfalls
Avoiding Therapeutic Nihilism
The GCS-P was specifically designed to solve the "GCS 3" problem. A patient with GCS 3 and fixed pupils (GCS-P 1) has ~90% mortality, whereas GCS 3 with reactive pupils (GCS-P 3) has ~33% mortality. This differentiation is critical for family counselling and surgical decision making.
Section 4
Evidence Appraisal
Primary Reference
Simplifying the use of prognostic information in traumatic brain injury. Part 1: The GCS-Pupils score: an extended index of clinical severity
Brennan PM et al. • J Neurosurg. 2018;128(6):1612-1620
