Abstract / Summary
Thyroid storm is a rare but life-threatening endocrine emergency, and tools for early risk stratification are needed. This study aimed to evaluate the prognostic utility of four severity scoring systems at admission in individuals with thyroid storm, with a particular focus on early identification of patients at high risk of adverse outcomes. This single-center retrospective study included 22 individuals diagnosed with thyroid storm between 2012 and 2024. Severity at admission was assessed using the Acute Physiology and Chronic Health Evaluation II, Sequential Organ Failure Assessment, quick Sequential Organ Failure Assessment, and the Burch–Wartofsky Point Scale. Outcomes were classified as favorable ( n = 18) or poor ( n = 4; in-hospital death or cardiopulmonary arrest requiring resuscitation, irrespective of subsequent ROSC). Severity scores were compared between outcome groups, and clinical parameters associated with poor outcomes were explored. All four severity scores were significantly higher in the poor outcome group. Exploratory receiver operating characteristic (ROC) analysis showed the highest discriminatory performance for the Burch–Wartofsky Point Scale, with a cutoff of ≥ 105 (sensitivity, 100.0%; specificity, 94.4%), although estimates were limited by the small number of poor outcomes. Poor outcomes were associated with markers of organ dysfunction, including coagulopathy, renal impairment, metabolic acidosis, impaired consciousness, thrombocytopenia, and atrial fibrillation. Although all patients with thyroid storm require immediate intensive management, the Burch–Wartofsky Point Scale may provide additional information for early risk stratification. Markedly elevated values were associated with adverse in-hospital outcomes, warranting validation in larger, independent cohorts. Not applicable.