Lille Model Calculator — Steroid Response in Alcoholic Hepatitis
Calculate the Lille score on day 7 of corticosteroids for severe alcoholic hepatitis from age, albumin, bilirubin on days 0 and 7, kidney function and prothrombin time — 0.45 or more means non-response.
How it works
R = 3.19 − 0.101 × age + 0.147 × albumin day 0 (g/L) + 0.0165 × (bilirubin day 0 − bilirubin day 7, µmol/L) − 0.206 × renal insufficiency (1 if creatinine > 1.3 mg/dL) − 0.0065 × bilirubin day 0 (µmol/L) − 0.0096 × PT (s). Lille = e^(−R) / (1 + e^(−R)). Lille ≥ 0.45 = non-response.
The Lille model (Louvet et al., Hepatology 2007) is used after 7 days of prednisolone for severe alcoholic hepatitis. It combines baseline age, albumin, bilirubin, kidney function and prothrombin time with the early fall in bilirubin. A score of 0.45 or more identified non-responders, whose 6-month survival was about 25% compared with about 85% in responders; continuing steroids in non-responders gives little benefit and raises infection risk. A later meta-analysis (Mathurin 2011) split responses into complete (≤ 0.16), partial and null (≥ 0.56).
Worked example
A 50-year-old with albumin 2.8 g/dL (28 g/L), bilirubin 15 mg/dL (256.5 µmol/L) on day 0 falling to 10 mg/dL (171 µmol/L) on day 7, normal creatinine and PT 18 s: R ≈ 1.827, so Lille = 0.139 — a responder (under 0.45, complete response pattern); steroids are usually continued to 28 days.
Sources: Louvet A et al. The Lille model: a new tool for therapeutic strategy in patients with severe alcoholic hepatitis treated with steroids. Hepatology 2007 · Mathurin P et al. Corticosteroids improve short-term survival in severe alcoholic hepatitis: meta-analysis of individual patient data. Gut 2011
Frequently asked questions
What is a good Lille score?
Below 0.45 means the patient is responding to corticosteroids, with an expected 6-month survival of about 85%. A score of 0.16 or less is a complete response.
When is the Lille score calculated?
On day 7 of corticosteroid treatment (some centres also use day 4). You need the day-0 values and the day-7 bilirubin.
What happens if the Lille score is 0.45 or more?
The patient is a non-responder; guidelines advise considering stopping steroids because they are unlikely to help and increase infection risk. Specialist options such as early transplant evaluation may be discussed.
Which units does the Lille model use?
The original equation uses albumin in g/L and bilirubin in µmol/L. Choose US units and the calculator converts mg/dL and g/dL automatically.
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Clinical decision tool for education and for use by trained clinicians alongside clinical judgement — not a diagnosis and not a substitute for medical assessment. Scores validated in specific populations may not apply to every patient.