ToolsCalculators
Burch-Wartofsky Point Scale for Thyrotoxicosis
Likelihood of thyroid storm in thyrotoxic patients.
Burch-Wartofsky Point Scale for Thyrotoxicosis
Temperature
Central nervous system effects
Gastrointestinal-hepatic dysfunction
Heart rate
Congestive heart failure
Atrial fibrillation
Precipitant history
Result0 points
Storm unlikely.
- Interpretation
- Storm unlikely
When to use
- Bedside estimate of the probability of thyroid storm in a thyrotoxic patient.
Formula
Sum weighted points for temperature, CNS, GI-hepatic, heart rate, CHF, atrial fibrillation and a precipitant. < 25 unlikely, 25–44 impending, ≥ 45 highly suggestive.
Pearls and pitfalls
- A clinical scale — treat empirically when suspicion is high rather than waiting for a threshold.
- Thyroid storm is a clinical diagnosis; hormone levels do not distinguish it from uncomplicated thyrotoxicosis.