ToolsCalculators
Myxedema coma diagnostic score
Semiquantitative likelihood of myxedema coma in severe hypothyroidism.
Myxedema coma diagnostic score
Thermoregulatory (temperature)
Central nervous system
Gastrointestinal
Cardiovascular - bradycardia
Other ECG changes (QT prolongation, low voltage, blocks, ST-T changes)
Pericardial/pleural effusion
Pulmonary oedema
Cardiomegaly
Hypotension
Hyponatraemia
Hypoglycaemia
Hypoxaemia
Hypercarbia
Decreased glomerular filtration rate
Precipitating event present
Result0 points
Myxedema coma unlikely (>=60 diagnostic, 25-59 at risk, <25 unlikely).
- Interpretation
- Myxedema coma unlikely
When to use
- Supporting the difficult clinical diagnosis of myxedema coma so that treatment is not delayed.
Formula
Sum of weighted points across thermoregulatory, CNS, GI, cardiovascular, metabolic domains and precipitating event. >=60 highly suggestive; 25-59 at risk; <25 unlikely.
Pearls and pitfalls
- A score >=60 was 100% sensitive and ~86% specific in the derivation study; treat empirically when suspicion is high.