Conservative medical treatment of ovarian hyperstimulation syndrome: a single center series and cost analysis study

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. Design Retrospective case series and cost analysis study using a decision-tree model. Setting University hospital. Population 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 (60g/day) and furosemide (20mg/8h). Main outcome measures 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): 2.8days 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$5193557). Cost of conservative medical treatment: US$570 (range US$2321640). 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.