Lille Score Calculator — Alcoholic Hepatitis Steroid Response
The Lille score uses six clinical variables measured at day 0 and day 7 of corticosteroid therapy to predict whether a patient with severe alcoholic hepatitis is responding to treatment. A score ≥ 0.45 indicates non-response and guides the decision to discontinue steroids.
years
g/L
µmol/L
µmol/L
µmol/L
seconds
Score 0–1; ≥ 0.45 = non-responder (consider stopping corticosteroids)
- 1
Δ Bilirubin (day 0 − day 7)
250 − 220 = 30Positive = bilirubin improving; contributes to lower (better) score. - 2
Renal insufficiency flag
0 (Cr ≤ 115 µmol/L) - 3
Linear predictor R
3.19 − 0.101×50 + 0.147×29 + 0.0165×30 − 0.206×0 − 0.0065×250 − 0.0096×18 = 1.1002 - 4
e^(−R)
e^(−1.1002) = 0.3328 - 5
Lille score = e^(−R) ÷ (1 + e^(−R))
0.3328 ÷ (1 + 0.3328) = 0.2497
How does this calculator work?
The Lille score = e⁻ᴿ / (1 + e⁻ᴿ) using six day-0 and day-7 variables in severe alcoholic hepatitis. Score < 0.16 = complete responder (≈ 91% survival); 0.16–0.45 = partial; ≥ 0.45 = non-responder (≈ 25% 6-month survival, consider stopping steroids). Validated for prednisolone 40 mg/day; always integrate with clinical context.
Formula
How this is calculated
The Lille model was developed and validated by Louvet et al. (Hepatology 2007) in patients with severe alcoholic hepatitis (Maddrey discriminant function ≥ 32) receiving prednisolone 40 mg/day. The model uses a logistic regression equation with six variables: age (years), baseline serum albumin (g/L), baseline total bilirubin (µmol/L), the change in bilirubin at day 7 (day 0 minus day 7, so a positive number means improvement), renal insufficiency at baseline (serum creatinine > 115 µmol/L = 1, else 0), and prothrombin time in seconds at baseline. These values give a linear predictor R, from which the score is computed as e⁻ᴿ / (1 + e⁻ᴿ), yielding a value between 0 and 1.
A Lille score below 0.16 indicates a complete responder (6-month survival ≈ 91%); 0.16 to 0.45 indicates a partial responder (≈ 70% survival); ≥ 0.45 indicates a null responder (≈ 25% 6-month mortality), in whom the benefits of continuing corticosteroids are unlikely to outweigh the risks. Some guidelines use the simplified cutoff of ≥ 0.45 to recommend discontinuation; others wait until day 28 before stopping.
Important limitations: the Lille score was derived and validated specifically in severe alcoholic hepatitis treated with prednisolone; it is not validated in patients receiving pentoxifylline or combination therapy. It does not capture the risk of infection on steroids, which is substantial. Clinical decision-making should integrate the Lille score with hepatic encephalopathy grade, evidence of infection, the MELD score, and local centre protocols. These 2007 survival estimates may differ from contemporary cohorts owing to changes in patient characteristics and supportive care.
Frequently asked questions
A Lille score ≥ 0.45 at day 7 of prednisolone therapy identifies non-responders with 6-month survival of approximately 25% on steroids — a survival rate that is not meaningfully improved by the treatment. Most guidelines recommend discontinuing corticosteroids in this group, since continuing exposes the patient to infection risk without proven benefit. Some centres extend therapy to day 14–28 before using the score if day-7 values are borderline.
ΔBilirubin = total bilirubin at day 0 (before starting corticosteroids) minus total bilirubin at day 7 of treatment, both in µmol/L. A positive value means bilirubin is falling (improvement), and a larger positive number contributes to a lower Lille score (better predicted response). A negative or zero change means bilirubin has not fallen, which drives the score higher.
The Maddrey discriminant function (MDF = 4.6 × (PT − control PT in seconds) + serum bilirubin in mg/dL) is calculated at baseline to decide whether to start corticosteroids — a score ≥ 32 indicates severe disease and probable benefit from steroids. The Lille score is used after 7 days of therapy to decide whether to continue steroids. They serve different purposes: MDF is an entry criterion, Lille is a response-to-treatment assessment.
Also known as
TG we-Calculate Editorial Team. (2026). Lille Score Calculator — Alcoholic Hepatitis Steroid Response [Online calculator]. TG we-Calculate. https://we-calculate.com/calculator/lille-score-calculator
TG we-Calculate Editorial Team. "Lille Score Calculator — Alcoholic Hepatitis Steroid Response." TG we-Calculate. 2026. https://we-calculate.com/calculator/lille-score-calculator.
TG we-Calculate Editorial Team, "Lille Score Calculator — Alcoholic Hepatitis Steroid Response," TG we-Calculate, 2026. [Online]. Available: https://we-calculate.com/calculator/lille-score-calculator
@misc{wecalculate_lille_score_calculator, title = {Lille Score Calculator — Alcoholic Hepatitis Steroid Response}, author = {{TG we-Calculate Editorial Team}}, howpublished = {\url{https://we-calculate.com/calculator/lille-score-calculator}}, year = {2026}, note = {TG we-Calculate} }
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