🦋 Burch-Wartofsky Score (Thyroid Storm)
UseSupport recognition of thyroid storm in thyrotoxicosis.
SourceBurch HB, Wartofsky L. Endocrinol Metab Clin 1993
This-shift next steps
After scoring: open the scene pack, peer scores, and the matching pathway. Local reference — no HIS write.
Paste the link in Slack, Teams, X, or LinkedIn — the preview image comes from this page’s Open Graph card.
Methodology · worked example, guidelines & full notes
The diagnosis is clinical — don't delay treatment.
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 | 38.3–38.8 (15) |
|---|---|
| CNS effects | Mild — agitation (10) |
| GI/hepatic dysfunction | Moderate — diarrhoea/nausea/pain (10) |
| Tachycardia | 110–119 (10) |
| Congestive heart failure | Mild — oedema (5) |
| Atrial fibrillation | Absent (0) |
| Precipitant history | Absent (0) |
→Burch-Wartofsky50
- Interpretation：Highly suggestive of thyroid storm
- Action：Treat as thyroid storm: beta-blocker, thionamide, iodine (after thionamide), steroids, supportive care.
| 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
Verification & sources · governance
FAQ
Frequently asked questions
- 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.
- Does Burch-Wartofsky Score (Thyroid Storm) upload patient data? Where is it calculated?
- Calculation runs locally in the browser; inputs and results are not uploaded. For licensed clinicians only; interpret with history, investigations and local protocols — not a diagnosis or prescription.
- How is Burch-Wartofsky Score (Thyroid Storm) calculated in practice? Can you show a worked example?
- Inputs: Temperature 38.3–38.8 (15), CNS effects Mild — agitation (10), GI/hepatic dysfunction Moderate — diarrhoea/nausea/pain (10), Tachycardia 110–119 (10), Congestive heart failure Mild — oedema (5), Atrial fibrillation Absent (0), Precipitant history Absent (0) → Result: Burch-Wartofsky 50（Interpretation: Highly suggestive of thyroid storm, Action: Treat as thyroid storm: beta-blocker, thionamide, iodine (after thionamide), steroids, supportive care.） 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）