head to head
How to Survive asks more than Fallout: New Vegas, and the gap is variance.

Optimization · Pure Optimization
A faction-driven RPG-shooter where build and route planning shape every ending.

Optimization · Pure Optimization
Crafting-tree planning and needs management under light zombie pressure.
Fallout: New Vegas leans Optimization (Pure Optimization); How to Survive leans Optimization (Pure Optimization).
Same score on execution - which means the number cannot separate them. The difference is in what each one asks of you.
Fallout: New Vegas
Shooter inputs with VATS assist
How to Survive
Twin-stick zombie kiting needs modest aim
Fallout: New Vegas leans a little harder on reads, though the gap is small.
Fallout: New Vegas
Scripted factions and enemies
How to Survive
Zombies are mindless scripted pressure
How to Survive leans clearly harder on variance.
Fallout: New Vegas
Some loot and crit RNG
How to Survive
Scavenged materials and island layouts are unknown until explored
Fallout: New Vegas leans a little harder on optimization, though the gap is small.
Fallout: New Vegas
Faction routing, perks, builds heavily rewarded
How to Survive
Crafting trees and needs management decide survival
A matching score does not mean a matching test. Two games can both sit at 10 on execution and demand completely different things of you - which is why the reasoning above matters more than the number beside it.