burch_wartofsky_score: Burch-Wartofsky Point Scale (BWPS) for Thyrotoxicosis

In cliot: Clinical Indices and Outcomes Tools

Burch-Wartofsky Point Scale (BWPS) for Thyrotoxicosis

Description

Calculates the Burch-Wartofsky Point Scale score to estimate the likelihood of Thyroid Storm in patients presenting with thyrotoxicosis. The scale aggregates scores from thermoregulatory dysfunction, central nervous system effects, gastrointestinal-hepatic dysfunction, cardiovascular tachycardia, heart failure, atrial fibrillation, and the presence of a precipitating history.

Usage

burch_wartofsky_score(temp_c, cns_scale, gi_scale, heart_rate, chf_scale,
                      afib_present, precipitating_event)

Arguments

temp_c	Numeric. Body temperature in degrees Celsius. 37.2-37.7: +5 pts. 37.8-38.2: +10 pts. 38.3-38.8: +15 pts. 38.9-39.3: +20 pts. 39.4-39.9: +25 pts. >= 40.0: +30 pts.
cns_scale	Numeric (0-3). Central Nervous System effects. 0: Absent. 1: Mild (Agitation). +10 pts. 2: Moderate (Delirium, psychosis, extreme lethargy). +20 pts. 3: Severe (Seizures, coma). +30 pts.
gi_scale	Numeric (0-2). Gastrointestinal-Hepatic dysfunction. 0: Absent. 1: Moderate (Diarrhea, nausea/vomiting, abdominal pain). +10 pts. 2: Severe (Unexplained jaundice). +20 pts.
heart_rate	Numeric. Heart rate in bpm. 99-109: +5 pts. 110-119: +10 pts. 120-129: +15 pts. 130-139: +20 pts. >= 140: +25 pts.
chf_scale	Numeric (0-3). Congestive Heart Failure severity. 0: Absent. 1: Mild (Pedal edema). +5 pts. 2: Moderate (Bibasilar rales). +10 pts. 3: Severe (Pulmonary edema). +15 pts.
afib_present	Numeric (0 or 1). Atrial Fibrillation present. (1 = Yes, +10 pts).
precipitating_event	Numeric (0 or 1). History of precipitating event (e.g., infection, surgery, trauma). (1 = Yes, +10 pts).

Value

A list containing:

BWPS_Score	The calculated total score.
Interpretation	Diagnostic likelihood (Unlikely < 25, Impending 25-44, Highly Suggestive >= 45).

References

Burch HB, Wartofsky L. Life-threatening thyrotoxicosis. Thyroid storm. Endocrinol Metab Clin North Am. 1993;22(2):263-277.

Examples

# Example 1: Highly Suggestive of Storm
# Temp 39.5 (+25), Mod CNS (+20), HR 145 (+25), No GI, No CHF, No Afib, Event (+10)
# Score = 80
burch_wartofsky_score(39.5, 2, 0, 145, 0, 0, 1)

# Example 2: Impending Storm
# Temp 38.0 (+10), Mild CNS (+10), HR 115 (+10), No other signs
# Score = 30
burch_wartofsky_score(38.0, 1, 0, 115, 0, 0, 0)

cliot documentation built on Dec. 1, 2025, 1:06 a.m.