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Thyroid Storm Scoring System

A scoring system has been devised to aid with the diagnosis of thyroid storm:
  • Scores greater than 45 are indicative of thyroid storm,
  • Scores 25-45 suggest thyroid storm, and
  • Scores less than 25 are unlikely to be thyroid storm.

    This system is probably best used as a clinical guideline rather than a strict formula to include or exclude thyroid storm as a diagnosis.
    Thermoregulatory
    Temp. (°F) Points
    99-100 5
    100-101 10
    101-102 15
    102-103 20
    103-104 25
    >104 30
    Cardiovascular
    Heart rate    Points
    100-110 5
    110-120 10
    120-130 15
    130-140 20
    >140 25
    CNS
    Alteration Points
    mild (agitation) 10
    moderate (delirium, psychois) 20

    Congestive Heart Failure
    Symptom Points
    mild
    pedal edema)
    5
    Moderate
    (bibasilar rales)
    10
    Severe
    (pulmonary edema)
    15
    Atrial fibrillation 10
    Gastrointestinal
    Symptom Points
    moderate (n/v/d, abd pain 10
    severe (jaundice) 20
    Precipitant History
    absent 0
    present 10


    Adapted from Burch HB, Wartofsky L. Endocrinology and Metabolism Clinics of North America. 1993; 22:263