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Burch & Wartofsky Diagnostic Criteria

Category Points
Thermoregulatory dysfunction (Temperature)
99-99.9 5
100-100.9 10
101-101.9 15
102-102.9 20
103-103.9 25
104 30
Central nervous system effects
Mild (Agitation) 10
Moderate (delirium, psychosis, extreme lethargy) 20
Severe (seizure, coma) 30
Thermoregulatory dysfunction (Temperature)
Mild (Agitation) 10
Moderate (delirium, psychosis, extreme lethargy) 20
Severe (seizure, coma) 30
Gastrointestinal-hepatic dysfunction
Moderate (diarrhea, n/v, abd pain) 10
Severe (unexplained jaundice) 20
Cardiovascular dysfunction (tachycardia)
99-109 5
110-119 10
120-129 15
130-139 20
140 25

V. Congestive Heart Failure

Mild (pedal edema) 5pts
Moderate (bibasilar rales) 10pts
Severe (pulm edema, A. fib) 15pts

VI. Precipitant history

Negative 0pts
Positive 10pts

Scoring

  • >45 = Highly suggestive of thyroid storm
  • 25-44 = Suggestive of impending storm
  • <25 = Unlikely to represent storm