Abstract

Acute surgical presentations include intra-abdominal emergencies and critical vascular and traumatic conditions. Early assessment and risk stratification are used to guide triage, operative decision-making, and quality standards in emergency settings. This study aimed to discuss articles on early assessment pathways, risk assessment tools, and operative management strategies in adults with acute surgical presentations. This systematic review followed PRISMA 2020 guidelines. Major databases were searched for studies that evaluated bedside physiologic assessment, laboratory and imaging integrated pathways, risk scores, and timing or approach of operative or endovascular intervention. Independent reviewers screened studies, extracted data, and assessed risk of bias with appropriate tools. The literature suggested that combining physiology, key laboratory markers, and focused imaging helps identify high-risk patients and prioritize urgent intervention. Several scores and pathway-based approaches might standardize early decisions and support service-level auditing. Heterogeneity in populations, score components, and outcomes limits direct comparisons and pooled conclusions. Structured early assessment and risk stratification improve safety and efficiency in emergency abdominal, vascular, and traumatic care. Future multicenter research would match outcome definitions and evaluate implementation to confirm which tools most improve patient and system outcomes.

Key words: Emergency general surgery, acute abdomen, risk stratification, triage, early assessment, systematic review.