🦋 Burch-Wartofsky Score (Thyroid Storm)
Estimate the likelihood of thyroid storm with the Burch-Wartofsky Point Scale.
The diagnosis is clinical — don't delay treatment.
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When to use
Support recognition of thyroid storm in thyrotoxicosis.
How it works
Points for temperature, CNS, GI-hepatic, heart rate, heart failure, atrial fibrillation and a precipitant. < 25 unlikely, 25–44 impending, ≥ 45 highly suggestive.
Key points
- The diagnosis is clinical — don't delay treatment.
- Treat storm with beta-blocker, thionamide, iodine (after thionamide) and steroids.
- ≥ 45 strongly suggests storm.
References
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| Temperature | < 37.2°C (0) |
|---|---|
| CNS effects | Absent (0) |
| GI/hepatic dysfunction | Absent (0) |
| Tachycardia | < 90 (0) |
| Congestive heart failure | Absent (0) |
| Atrial fibrillation | Absent (0) |
| Precipitant history | Absent (0) |
→Burch-Wartofsky0
- Interpretation：Thyroid storm unlikely
| Temperature | ≥ 40 (30) |
|---|---|
| CNS effects | Severe — seizure/coma (30) |
| GI/hepatic dysfunction | Severe — jaundice (20) |
| Tachycardia | ≥ 140 (25) |
| Congestive heart failure | Severe — pulmonary oedema (15) |
| Atrial fibrillation | Present (10) |
| Precipitant history | Present (10) |
→Burch-Wartofsky140
- Interpretation：Highly suggestive of thyroid storm
- Action：Treat as thyroid storm: beta-blocker, thionamide, iodine (after thionamide), steroids, supportive care.
Frequently asked questions
- What is Burch-Wartofsky Score (Thyroid Storm)?
- Estimate the likelihood of thyroid storm with the Burch-Wartofsky Point Scale.
- How is Burch-Wartofsky Score (Thyroid Storm) calculated? What is the core formula?
- Points for temperature, CNS, GI-hepatic, heart rate, heart failure, atrial fibrillation and a precipitant. < 25 unlikely, 25–44 impending, ≥ 45 highly suggestive.
- When is Burch-Wartofsky Score (Thyroid Storm) used?
- Support recognition of thyroid storm in thyrotoxicosis.
- What are the key clinical points for Burch-Wartofsky Score (Thyroid Storm)?
- The diagnosis is clinical — don't delay treatment. Treat storm with beta-blocker, thionamide, iodine (after thionamide) and steroids. ≥ 45 strongly suggests storm.
- What are the limits and cautions when using Burch-Wartofsky Score (Thyroid Storm)?
- For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.
- How is Burch-Wartofsky Score (Thyroid Storm) calculated in practice? Can you show a worked example?
- Inputs: Temperature < 37.2°C (0), CNS effects Absent (0), GI/hepatic dysfunction Absent (0), Tachycardia < 90 (0), Congestive heart failure Absent (0), Atrial fibrillation Absent (0), Precipitant history Absent (0) → Result: Burch-Wartofsky 0（Interpretation: Thyroid storm unlikely） Inputs: Temperature ≥ 40 (30), CNS effects Severe — seizure/coma (30), GI/hepatic dysfunction Severe — jaundice (20), Tachycardia ≥ 140 (25), Congestive heart failure Severe — pulmonary oedema (15), Atrial fibrillation Present (10), Precipitant history Present (10) → Result: Burch-Wartofsky 140（Interpretation: Highly suggestive of thyroid storm, Action: Treat as thyroid storm: beta-blocker, thionamide, iodine (after thionamide), steroids, supportive care.）