The Burch-Wartofsky Point Scale (BWPS) for Thyrotoxicosis determines likelihood of thyrotoxicosis independent of thyroid hormone levels.

Thyroid storm (TS) is an endocrine ... treatment prevents a catastrophic outcome (2,3). In a recent manuscript, the TS is estimated to be 0.2 persons/100,000 population/year, accounting for 0.22% of all thyrotoxic patients (3)....

A score of 45 or greater is highly suggestive of thyroid storm; a score of 25–44 is suggestive of impending thyroid storm, and a score below 25 is unlikely to represent thyroid storm.

Burch-Wartofsky Point Scale for the Diagnosis of Thyroid Storm. When it is not possible to distinguish the effects of an intercurrent illness from those of severe thyrotoxicosis per se, points are awarded such as to favor the diagnosis of storm and hence, empiric therapy.

Table I. Diagnostic Criteria for Thyroid Storm:

Fever above 100.4 °F (38 °C) accrues the maximum score, emphasizing its role as a significant temperature indicator.[1] The scale delves into Central Nervous System (CNS) manifestations, encompassing agitation, delirium, psychosis, and seizures, ...

Evaluate thyroid storm using the Burch-Wartofsky Point Scale and JTA criteria. Compare diagnostic tools, recognize critical symptoms, and guide urgent management of this endocrine emergency.

October 8, 2023 - ↑ Isozaki O et al. Treatment and management of thyroid storm: analysis of the nationwide surveys: The taskforce committee of the Japan Thyroid Association and Japan Endocrine Society for the establishment of diagnostic criteria and nationwide surveys for thyroid storm.

December 2, 2025 - 2) Treatment for thyroid storm is reasonable in any patient with severe hyperthyroidism causing organ failure (especially heart failure). Therefore, even if the patient's score is < 45, it may be prudent to initiate thyroid storm therapy.

October 4, 2025 - For instance, Burch and Wartofsky ... Burch-Wartofsky score below 25 is not suggestive of thyroid storm whereas 25 to 45 suggests impending thyroid storm and greater than 45 suggests current thyroid storm....

A retrospective study by Bourcier et al of 31 French intensive care units (ICUs) found that in ICU patients with thyroid storm, multiple organ failure (as evaluated using the Sequential Organ Failure Assessement [SOFA] score, absent the cardiovascular component), and the occurrence, within 48 hours following ICU admission, of cardiogenic shock are independent risk factors for mortality in the ICU.

Following surgery and transfer to the recovery room, the patient demonstrated delayed emergence from anesthesia, with a Burch-Wartofsky score of 45 and persistent tachycardia (heart rate 144 bpm), meeting Grade 1 thyroid storm criteria per Japan ...

August 16, 2025 - Compared with typical Hyperthyroidism, Thyroid Storm presents with more severe secondary symptoms · Fever · Altered Mental Status (e.g. Delirium) Dyspnea (including Orthopnea) Chest Pain · Diplopia · Gastrointestinal symptoms may also be present · Nausea or Vomiting · Abdominal Pain · Hepatic dysfunction · Signs · See Thryoid Storm Diagnosis (Burch Wartofsky Score) Constitutional ·

October 6, 2022 - Diagnosis: A score of more than 45 highly suggests thyroid storm, 25 to 44 supports the diagnosis, and less than 25 makes the diagnosis unlikely.

Fever above 100.4 °F (38 °C) accrues the maximum score, emphasizing its role as a significant temperature indicator.[1] The scale delves into Central Nervous System (CNS) manifestations, encompassing agitation, delirium, psychosis, and seizures, with points assigned commensurate with ...

Burch-Wartofsky Point Scale (BWPS) is a scoring system to help identify thyroid storm.

August 26, 2022 - Burch and Wartofsky (1993) introduced ... these criteria, a score of < 25 points indicates that a thyroid storm is unlikely; 25-44 points an impending thyroid storm; and ≥ 45 points, thyroid storm....

August 5, 2013 - Thyroid storm, an endocrine emergency first described in 1926, remains a diagnostic and therapeutic challenge. No laboratory abnormalities are specific to thyroid storm, and the available scoring system is based on the clinical criteria. The exact mechanisms underlying the development of thyroid storm from uncomplicated hyperthyroidism are not well understood.

March 1, 2016 - Graves disease, toxic adenoma, and toxic multinodular goiter can sometimes cause severe hyperthyroidism, which is termed a thyroid storm. The Burch-Wartofsky score is a helpful tool for diagnosing thyroid storm37 (eTable B).