Calculate the Lille Model score for early bilirubin response in severe alcoholic hepatitis and review the result as prognostic context after the first treatment week.
The Lille Score estimates early bilirubin response after about 7 days of treatment in severe alcoholic hepatitis. It uses age, albumin, day 0 and day 7 bilirubin, creatinine, and prothrombin time to summarize prognosis and separate lower versus higher early-response patterns.
Severe alcoholic hepatitis carries substantial short-term mortality, and the Lille model is one of the tools specialists use when reviewing whether the first treatment week looks favorable or unfavorable. Lower scores suggest a better early response, while higher scores suggest a worse outlook.
This calculator separates complete responders, partial responders, and non-responders so the prognostic discussion is easier to frame in context.
The Lille score is useful because early bilirubin response often says more than the starting severity alone. It helps summarize whether the first treatment week looks favorable, intermediate, or poor without relying on bilirubin change alone.
Lille Score = exp(-R) / (1 + exp(-R)) R = 3.19 − 0.101 × age + 0.147 × albumin(g/L) + 0.0165 × Δbilirubin(μmol/L) − 0.206 × renal insufficiency − 0.0065 × bilirubin Day 0(μmol/L) − 0.0096 × PT(seconds) Renal insufficiency = 1 if creatinine >1.3 mg/dL Δbilirubin = Day 0 − Day 7 bilirubin (μmol/L)
Result: Lille 0.18 — Partial Responder
Bilirubin decreased from 12 to 8 mg/dL (33% drop), with Lille 0.18 indicating partial response. That is generally treated as a more favorable early pattern than a rising or unchanged bilirubin, but it still needs to be read with infection status, renal function, and overall severity.
Baseline severity scores describe how sick the patient looks at the start. Lille adds a second question: did bilirubin improve meaningfully after the first treatment week? That follow-up signal is why the model is still widely used as a prognostic checkpoint.
The Lille score is useful precisely because it is simple, but that simplicity also means it cannot capture the whole picture. Infection, renal failure, nutrition status, encephalopathy, and broader liver-severity measures still shape prognosis. The most defensible use of the page is as a response-classification aid, not as a stand-alone therapy algorithm.
A higher score points to poorer early bilirubin response and worse expected short-term outcomes. That is useful prognostic information, but the next clinical step still depends on the broader hepatology assessment rather than the number alone.
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This calculator applies the Lille model as a day-7 corticosteroid response assessment for severe alcoholic hepatitis, combining age, albumin, baseline bilirubin, day-7 bilirubin change, prothrombin time, and renal status into the usual responder-versus-nonresponder framework. The page is intended to support the decision about whether continuing corticosteroids after the first treatment week remains worthwhile.
The output should only be interpreted in the setting the model was designed for: severe alcoholic hepatitis already being treated with corticosteroids. It is not a general liver-failure score and should be used alongside the broader management plan, including infection review, nutritional support, and transplant evaluation where appropriate.
Day 7 is defined as 7 full days after starting prednisolone. Draw the morning bilirubin on Day 7 of treatment (not Day 7 of hospitalization, which may differ). Some centers also use Day 4 bilirubin for earlier assessment using modified Lille models.
The Lille model is probabilistic, not absolute. If there is clear clinical improvement, clinicians may weigh the full picture rather than the score alone, but a high Lille score still signals poor expected steroid response.
A higher Lille score is associated with worse short-term prognosis, but it is still only one part of the overall assessment. Infection, renal injury, nutrition, encephalopathy, and baseline liver severity still matter.
The Maddrey DF = 4.6 × (PT − control PT) + bilirubin (mg/dL). DF ≥32 defines "severe" alcoholic hepatitis and is the threshold for considering corticosteroid therapy. The Lille score is only applicable to patients who have started steroids for severe AH (typically DF ≥32).
Adjunctive therapy decisions vary by center and guideline set. This calculator does not determine medication choice; it only summarizes the Lille score itself.
Younger age, lower baseline bilirubin, preserved renal function, and higher albumin are associated with better Lille responses. Infection at presentation and ACLF grade 3 predict non-response. Early aggressive nutritional support (35-40 kcal/kg/day) may also improve steroid response rates.