Burch-Wartofsky Score (Thyroid Storm)
Quantifies likelihood of thyroid storm (thyrotoxic crisis). Score >= 45 = thyroid storm; 25-44 = impending storm.
Score interpretation
→ Not thyroid storm; investigate other causes of tachycardia/fever; optimise thyroid function
→ High suspicion; treat as thyroid storm: propylthiouracil (PTU), iodine (1 hour after PTU), beta-blocker, hydrocortisone; ICU monitoring
→ Thyroid storm: ICU; PTU 200-400mg TID (or carbimazole); saturated potassium iodide (SSKI) after PTU; propranolol; IV hydrocortisone 300mg then 100mg TID; cooling; treat precipitant
Interpretation bands for the Burch-Wartofsky. Apply clinical judgement and local guidance.
References
Related
Curated clinical cross-links plus same-class fallbacks.
- Tocilizumab (ICU — Cytokine Storm / COVID-19) · IL-6 Receptor Inhibitor
- Labetalol (IV — Hypertensive Emergency) · Combined Alpha-1 and Beta-Adrenergic Blocker
- Labetalol (IV — Hypertensive Emergency) · Combined alpha and beta blocker
- Tenecteplase · Cardiovascular Emergency
- Tirofiban · Cardiovascular Emergency
- Terlipressin · Gastrointestinal Emergency
- Diabetic Ketoacidosis (DKA) · JBDS 2013 / Joint British Diabetes Societies; NICE NG17
- Adult Hypoglycaemia (Treated Diabetes) · JBDS-IP (2023): Hospital Management of Hypoglycaemia
- Adrenal Crisis · Society for Endocrinology Emergency Guidance (2024)
- Type 2 Diabetes Management · NICE NG28 2022
- Hyperthyroidism Management · BTA / ETA 2018
- Adrenal Insufficiency · Society of Endocrinology / ESE 2016
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.