🦋 Burch-Wartofsky Score (Thyroid Storm)
Estimate the likelihood of thyroid storm with the Burch-Wartofsky Point Scale.
Burch-Wartofsky Score (Thyroid Storm)
Temperature
CNS effects
GI/hepatic dysfunction
Tachycardia
Congestive heart failure
Atrial fibrillation
Precipitant history
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
Decision support for licensed clinicians only; not a substitute for clinical judgement, diagnosis or local protocols.