Hospital-based surgical case volume and severity of acute appendicitis: 7-year temporal trends (2019–2025) at a Vietnamese tertiary center

Purpose: Acute appendicitis is the most common abdominal surgical emergency worldwide, but hospital-based surgical case volume and disease severity continue to vary over time. Regional differences, the COVID-19 pandemic, and changes in surgical management indicate the need for updated local data.Methods: We conducted a retrospective study of all patients who underwent appendectomy for acute appendicitis at Nhan dan Gia Dinh Hospital, a tertiary referral hospital in Ho Chi Minh City, Vietnam, between January 2019 and July 2025. Data were extracted from electronic medical records and included demographic characteristics, disease severity, operative approach, and operative time. Temporal patterns were analyzed by year, month, and time of day.Results: A total of 7,768 patients were included. Uncomplicated appendicitis accounted for most cases, and patients with complicated appendicitis were older than those with uncomplicated disease. Female patients constituted a slight majority. Overall case numbers declined markedly in 2021, coinciding with the peak of the COVID-19 pandemic, and then stabilized. Seasonal variation was observed. Laparoscopy was the predominant operative approach, accounting for 99% of cases. The mean operative time was 75 minutes. Nighttime operations were associated with slightly longer operative times overall than daytime operations (77 minutes vs. 74 minutes), including among patients with peritonitis.Conclusion: Over 7 years, hospital-based surgical case volume for acute appendicitis declined, whereas the proportion of complicated cases remained stable. Temporal fluctuations indicate dynamic changes in case numbers. Laparoscopy remained the predominant approach, reflecting sustained use of minimally invasive surgery.