Aim: This retrospective study aimed to investigate the combined accuracy of appendix diameter, C reactive protein, and Alvarado score in classifying patients with negative appendectomy and acute appendicitis. Material and Methods: This descriptive observational cohort study research was conducted at the Emergency Department of a Training and Research Hospital between November 2017 and April 2019. We included the data of appendicitis cases aged under 18 years in this restrospective study and gathered data on patients’s demographics, preoperative laboratory values, signs, symptoms, and final pathological diagnosis, restrospectively. Then, cases were divided into acute appendicitis or negative appendectomy groups according to formal pathology reports. Results: The final study population consisted of 60 patients; the negative appendectomy rate was 25%. The diagnostic accuracy of the multivariate model`s involving CRP, Alvarado score, and appendix diameter was 93.3%, with a sensitivity and specificity of 93.3% for identifying acute appendicitis (+LR: 14 and -LR: 0.07). Applying the model could have prevented 93.3% of negative appendectomy cases (25% to 1.7%) from undergoing unnecessary surgery in our cohort. Conclusion: In conclusion, CRP, Alvarado score, or appendix diameter should not be used individually to diagnose AA in children. However, combining these variables can increase the accuracy of acute appendicitis diagnosis and may provide a significant reduction in negative appendectomy rates.

Acute appendicitis is one of the most common surgical causes of an acute abdomen among patients admitted to the emergency room due to abdominal pain. The clinical diagnosis of acute appendicitis is usually difficult and is made by evaluating the clinical, laboratory, and radiological findings together. The aim of this study was to investigate the diagnostic potential of signal peptide-CUB-EGF-like domain-containing protein 1 as a biomarker for acute appendicitis.

Objective: It is aimed to examine the numerical change in the emergency department patient admissions of a third-level hospital on public holidays and to offer solutions to the overcrowding in the emergency department with these data.Material and Methods: The records of patients who were admitted to the emergency department between 01.01.2015 and 31.12.2018 were analyzed retrospectively. The age, gender, admission date data of the patients during the study period were recorded and compared by determining the official holidays and other working days.Results: During the specified date range, 543,138 patient admissions were made, and 52% of them were men. The mean age of the patients was 41 years. August (10.2%) was the month with the highest number of patient admissions; Monday (15.5%) was the day with the highest number of patient admissions. It was observed that the admissions were mostly in the 12:00-18:00 time zone (33.6%). In the emergency department, where the average number of patients per day was 366, an average of 503 patients admissions were made on public holidays on weekdays (p<0.001).Conclusion: Emergency department patient density exhibits temporal differences. Emergency department applications show a significant increase during public holidays that coincide with weekdays.