Diagnosis of Thyrotoxic Storm
| Criteria | Points |
|---|---|
| Thermoregulatory dysfunction | |
| Temperature | |
| Less than 37.2°C (99.0°F) | 0 |
| 37.2–37.7°C (99.0–99.9°F) | 5 |
| 37.8–38.2°C (100.0–100.9°F) | 10 |
| 38.3–38.8°C (101.0–101.9°F) | 15 |
| 38.9–39.3°C (102.0–102.9°F) | 20 |
| 39.4–39.9°C (103.0–103.9°C) | 25 |
| 40.0°C or higher (104°F or higher) | 30 |
| Cardiovascular | |
| Heart Rate | |
| Less than 100 | 0 |
| 100–109 | 5 |
| 110–119 | 10 |
| 120–129 | 15 |
| 130–139 | 20 |
| 140 or higher | 25 |
| Atrial fibrillation | |
| Absent | 0 |
| Present | 10 |
| Congestive heart failure | |
| Absent | 0 |
| Mild | 5 |
| Moderate | 10 |
| Severe | 20 |
| Gastrointestinal/hepatic dysfunction | |
| Manifestation | |
| Absent | 0 |
| Moderate (diarrhoea, abdominal pain, nausea/vomiting) | 10 |
| Severe (jaundice) | 20 |
| Central nervous system disturbance | |
| Manifestation | |
| Absent | 0 |
| Mild (agitation) | 10 |
| Moderate (delirium, psychosis, extreme lethargy) | 20 |
| Severe (seizure/coma) | 30 |
| Precipitant history | |
| Status | |
| Present | 0 |
| Absent | 10 |
| Interpretation | |
| Total score | Interpretation |
| <25 | Thyrotoxic storm unlikely |
| 25–45 | Impending thyrotoxic storm |
| >45 | Thyrotoxic storm confirmed |
Source: Burch HB, Wartofsky L (1993) Life-threatening hyperthyroidism: thyroid storm. Endocrinol Metab Clin North Am 22, 263–277. Reproduced with permission of Elsevier.