Abstract

Abstract
Multi system trauma including maxillofacial, neck, chest, and pelvic injuries creates challenging priorities in the emergency department (ED) and worsen outcomes when injuries are missed or interventions are delayed. We conducted a PRISMA guided systematic review. PubMed, PubMed Central (PMC), Scopus, and Web of Science were searched for original studies evaluating ED assessment strategies and report clinical outcomes in trauma patients with injuries affecting the face or the target system. After duplicate removal, we perform two-stage screening. Data were extracted using a standardized form (study design, setting, population, injury patterns, ED strategies, and outcomes). Risk of bias was assessed using appropriate tools. Because of heterogeneity in designs and outcomes, results were analyzed qualitatively and summarized in tables. nine studies were included, large retrospective cohorts, multicenter registries, and prospective cohorts. In studies, maxillofacial injuries were the most ED burden, with common midface fracture patterns and frequent soft-tissue injuries. Several cohorts found clinically important associated injuries. Standardized documentation templates improved completeness of key assessments, and clinical examinations improved diagnostic confidence and fracture discrimination. studies supports structured ED assessment, timely imaging, and coordinated multidisciplinary pathways to reduce omissions in multi-system trauma. Researchers should focus on prospective multicenter evaluations of integrated algorithms.

Key words: Multi-system trauma; polytrauma; emergency department; maxillofacial injuries; neck trauma; blunt chest trauma; pelvic fracture; clinical pathways; computed tomography.