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Burch-Wartofsky-Score

Synonym: Burch-Wartofsky point scale
German: Burch-Wartofsky-Score

1 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.

2 Calculation

2.1 Temperature

 Celsius  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

2.2 Central Nervous Effects

Symptoms  Points
Missing0 Points
Mild (agitation)10 Points
Moderate (delirium, psychosis, extreme lethargy)20 Points
Severe (seizures, coma)30 Points

2.3 Hepatogastroinestinal Dysfunction

Symptoms  Points
Missing0 Points
Moderate (diarrhea, nausea, vomiting, abdominal pain)10 Points
Severe (unexxplained jaundice)20 Points

2.4 Cardiovascular Dysfunction 1

 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

2.5 Cardiovascular Dysfunction 2

Symptoms  Points
Mssing0 Points
Mild (pedal edemas)5 Points
Moderae (bibasilar rales)10 Points
Severe (pulmonary edema)15 Points

2.6 Cardiovascular Dysfunction 3

Arrhythmia  Points
Missing0 Points
Present10 Points

2.7 Suggestive History

History  Points
Mssing0 Points
Present10 Points

The summed up point values deliver the score.

3 Assessment

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

4 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)

5 Web-Links

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

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