Burch-Wartofsky-Score

Synonym: Burch-Wartofsky point scale

	Table of contents
	1. Overview and Definition 2. Calculation 2.1. Temperature 2.2. Central Nervous Effects 2.3. Hepatogastroinestinal Dysfunction 2.4. Cardiovascular Dysfunction 1 2.5. Cardiovascular Dysfunction 2 2.6. Cardiovascular Dysfunction 3 2.7. Suggestive History 3. Assessment 4. References 5. Web-Links

Overview and Definition

The Burch-Wartofsky-Score is a point scale that halps to assess of the probability of thyrotoxicosis independently from the level of thyroid hormones. It is solely based on clinical and physical criteria.

The point scale covers body temperature, central nervous effect, hepatogastrointestinal symptoms, cardiovascular dysfunction and the patient's history.

Calculation

Temperature

	°Celsius  Â°Fahrenheit  Points < 37,7 °C < 99,9 °F 5 Points 37.8 - 38.3 °C 100 - 100.9 °F 10 Points 38.4 - 38.8 °C 101 - 101.9 °F 15 Punkte 38.9 - 39.4 °C 102 - 102.9 °F 20 Points 39.5 - 39.9 °C 103 - 103.9 °F 25 Points >= 40 °C >= 104 °F 30 Points

Central Nervous Effects

	Symptoms  Points Missing 0 Points Mild (agitation) 10 Points Moderate (delirium, psychosis, extreme lethargy) 20 Points Severe (seizures, coma) 30 Points

Hepatogastroinestinal Dysfunction

	Symptoms  Punkte Missing 0 Points Moderate (diarrhea, nausea, vomiting, abdominal pain) 10 Points Severe (unexxplained jaundice) 20 Points

Cardiovascular Dysfunction 1

	Tachycardia
	Pulse frequeny  Points 90 - 109 / Minute 5 Points 110 - 119 / Minute 10 Points 120 - 129 / Minute 15 Points 130 - 139 / Minute 20 Points >= 140 / Minute 25 Points

Cardiovascular Dysfunction 2

	Congestive Heart Failure
	Symptoms  Points Mssing 0 Points Mild (pedal edemas) 5 Points Moderae (bibasilar rales) 10 Points Severe (pulmonary edema) 15 Points

Cardiovascular Dysfunction 3

	Atrial Fibrillation
	Arrhythmia  Punkte Missing 0 Points Present 10 Points

Suggestive History

	History  Points Mssing 0 Points Present 10 Points

The summed up point values deliver the score.

Assessment

With a score over 25 points thyotoxicosis is possible, a score over 45 points renders it probable.

References

Burch, H. B. und L. Wartofsky (1993). "Life-Threatening Thyrotoxicosis. Thyrotoxic storm. " Endocrinology and Metabolism Clinics of North America 22(2): 263-77. (>> Abstract)

Web-Links

Online-Calculator for Burch-Wartosky-Score (formatio reticularis)