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Lille Score Calculator
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.
Medical Disclaimer: The Lille score is a prognostic worksheet used after about 7 days of treatment in severe alcoholic hepatitis. It supports specialist discussion; it is not a stand-alone treatment order set.
years
g/dL
mg/dL
mg/dL
mg/dL
seconds
▼
0 (best)0.160.561.0 (worst)
Lille Score
0.203
Partial Responder
6-month mortality: ~25%
Bilirubin Response (Day 0 → Day 7)
12
Day 0
→
8
Day 7
↓33%
Lille Score⧉
0.203
Partial Responder
Response Category⧉
Partial Responder
Intermediate response range that usually needs full clinical context
6-Month Mortality⧉
~25%
Based on steroid response category
Bilirubin Change⧉
33%
12 → 8 mg/dL (Day 0→7)
Renal Insufficiency⧉
No
Adverse prognostic factor
Interpretation Context⧉
Ongoing response assessment
Usually interpreted alongside infection status, renal function, nutrition, and the rest of the liver picture
| Lille Score | Category | 6-Month Mortality | Context |
|---|---|---|---|
| <0.16 | Complete Responder | ~15% | Usually interpreted as a strong early bilirubin response |
| 0.16-0.56 | Partial Responder | ~25% | Intermediate range that benefits from full specialist context |
| ≥0.56 | Non-Responder | ~75% | Often treated as poor early response rather than a stand-alone treatment order |
| Variable | Value | Prognostic Impact |
|---|---|---|
| Age | 50 years | Older age → worse prognosis |
| Albumin | 2.5 g/dL | <2.5 = poor synthetic function |
| Day 0 Bilirubin | 12 mg/dL | Higher baseline → worse prognosis |
| Day 7 Bilirubin | 8 mg/dL | Declining = favorable response |
| Creatinine | 1.2 mg/dL | >1.3 = renal insufficiency (poor sign) |
| PT | 25 sec | Prolonged = coagulopathy |
Planning notes, formulas, and examples
About the Lille Score Calculator
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.
When This Page Helps
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.
How to Use the Inputs
- Confirm severe alcoholic hepatitis in the clinical setting where Lille scoring is appropriate.
- Record Day 0 values: bilirubin, albumin, creatinine, PT.
- Recheck bilirubin at Day 7.
- Enter all values into the calculator.
- Use the score as prognostic context alongside the rest of the liver-injury picture.
Formula used
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)Example Calculation
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.
Tips & Best Practices
- Use Lille only in the setting where Day 0 and Day 7 bilirubin values are available and the clinical team already considers the model appropriate.
- Rising bilirubin by Day 7 generally pushes the score higher and signals a worse early pattern.
- Renal insufficiency at admission is one of the strongest adverse prognostic factors.
- Interpret Lille together with broader liver-severity tools such as MELD or Maddrey DF rather than in isolation.
- Nutrition, infection status, and renal injury remain important even when the score is favorable.
What Lille Adds Beyond Baseline 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.
Why the Score Should Stay in Context
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.
What a Higher Score Means
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.
Sources & Methodology
Last updated:
Methodology
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.
Sources
- The Lille model: a new tool for therapeutic strategy in patients with severe alcoholic hepatitis treated with steroids (PubMed / Hepatology)
- ACG Clinical Guideline: Alcoholic Liver Disease (PubMed / American Journal of Gastroenterology) — Guideline context for corticosteroid use and response assessment in severe alcoholic hepatitis.
Frequently Asked Questions
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 Complete View 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.
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