Factors and precipitation and scaling of thyroid storm prediction
Precipitating Factors (common triggers):
Infection (e.g., pneumonia, urinary tract infection)
Trauma, surgery (e.g., thyroidectomy, radioiodine therapy)
Discontinuation of antithyroid medications in thyrotoxicosis
Myocardial infarction, stroke
Diabetic ketoacidosis, pregnancy, labor
Clinical Features (Burch-Wartofsky Point Scale for diagnosis):
Temperature >38°C (1 point per degree above 37°C)
Heart rate >140 bpm (1 point per 10 bpm above 140)
Systolic blood pressure >140 mmHg (1 point per 20 mmHg above 140)
Congestive heart failure (5 points)
Atrial fibrillation (5 points)
Precipitating event (e.g., infection, surgery; 10 points)
Score ≥45 suggests thyroid storm (sensitivity ~90%). –
Laboratory Findings:
Elevated free T4, free T3, suppressed TSH
Hyperglycemia, leukocytosis, elevated liver enzymes
Rationale: Prediction relies on identifying high-risk triggers and recognizing early signs of decompensation. The Burch-Wartofsky scale aids in objective diagnosis.