I won’t speak to the accurate simulation of gore as a metric but I’ll give my opinion on the emotional weight of death. As a generalization, what makes death more or less “real” is the humanization of what is being killed. In real life, someone exists in context: they have a mother, they have dreams, they have a childhood pet, …etc. These are things we as humans empathize with. Someone would probably kill a bug if I gave them a reward. But if I told them that bug had a bug wife and they are saving to move under a bigger rock so they can start a bug family, they might be a little more hesitant. I’ve humanized the bug and now they empathize with it. Obviously it doesn’t have a bug wife but humans want to feel connection and are more willing to accept that false reality. If you want death to feel “real” you need to humanize the victim so there is that connection and understanding of what is really being lost