title: Conservative medical treatment of ovarian hyperstimulation syndrome: a single center series and cost analysis study.
abstract: OBJECTIVE
  To present the results of a large series of patients with ovarian hyperstimulation syndrome treated with a conservative medical approach and to compare the cost of this treatment with outpatient management with paracentesis according to published data.
  
  
  METHODS
  Retrospective case series and cost analysis study using a decision-tree model.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  496 consecutive patients with ovarian hyperstimulation syndrome treated in our center from 1991 to 2010.
  
  
  METHODS
  All patients were treated with a conservative medical approach: (a) conservative outpatient approach: bed rest and a low-sodium diet or (b) hospitalized patients: bed rest, low-sodium diet, 20% albumin (60 g/day) and furosemide (20 mg/8 h).
  
  
  METHODS
  Percentage of admissions, length of hospital stay and readmissions. Total cost of each therapeutic approach.
  
  
  RESULTS
  (a) Conservative outpatient approach (n = 377): all cases solved without admission. (b) Hospitalized patients with conservative medical treatment (n = 119): 2.8 days of mean hospital stay, no patient required paracentesis or admission to intensive care unit. Readmissions: Five patients (4.2%) resolved on restarting medical treatment. (c) Cost-analysis comparison: Cost of the outpatient approach with paracentesis: US$980 (range US$519-3557). Cost of conservative medical treatment: US$570 (range US$232-1640).
  
  
  CONCLUSIONS
  Ovarian hyperstimulation syndrome can be safely managed with a conservative medical approach, which was not found to be more expensive than outpatient management with paracentesis.
authors: Assisted Reproduction Unit, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer Faculty of Medicine, University of Barcelona, Barcelona, Spain. jbalasch@ub.edu
authors: Gemma
authors: G
authors: Casals
authors: Francisco
authors: F
authors: Fábregues
authors: Marco
authors: M
authors: Pavesi
authors: Vicente
authors: V
authors: Arroyo
authors: Juan
authors: J
authors: Balasch
mesh_terms: D000418:Albumins / Q000008:administration & dosage; D000553:Ambulatory Care / Q000191:economics; D001510:Bed Rest; D003365:Costs and Cost Analysis; D003663:Decision Trees; D004039:Diet, Sodium-Restricted; D004232:Diuretics / Q000627:therapeutic use; D005260:Female; D005665:Furosemide / Q000627:therapeutic use; D006400:Hematocrit; D006760:Hospitalization / Q000191:economics; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D016471:Ovarian Hyperstimulation Syndrome / Q000191:economics* / Q000628:therapy*; D019152:Paracentesis / Q000191:economics; D010359:Patient Readmission / Q000706:statistics & numerical data; D010952:Plasma Substitutes / Q000008:administration & dosage; D010996:Pleural Effusion / Q000453:epidemiology; D012189:Retrospective Studies; D012964:Sodium / Q000652:urine
chemical_list: D000418:Albumins; D004232:Diuretics; D010952:Plasma Substitutes; D005665:Furosemide; D012964:Sodium