Lille Score Calculator

What Is the Lille Score?

The Lille Score is a validated clinical model used to evaluate a patient's response to corticosteroid therapy in the context of severe alcoholic hepatitis. It is calculated after seven days of treatment to determine whether continuing steroids is likely to provide benefit or whether the therapy should be stopped due to lack of response.

This score combines six variables: age, renal function (creatinine), albumin, prothrombin time (or INR), bilirubin at day 0, and the change in bilirubin after one week of treatment. The result is a score between 0 and 1, with lower scores indicating a favorable response and higher scores suggesting treatment futility.

How the Lille Score Is Calculated

The Lille model uses logistic regression to produce a probability score. The formula incorporates the following patient data:

• Age — older age is associated with worse outcomes
• Serum creatinine (µmol/L or mg/dL) — reflects renal function
• Serum albumin (g/L) — a marker of liver synthetic function
• Prothrombin time (seconds) or INR — indicates coagulation status
• Serum bilirubin at day 0 (µmol/L or mg/dL) — baseline disease severity
• Change in bilirubin after 7 days of treatment — the key dynamic variable

The model produces a score from 0 to 1. A Lille score below 0.45 is generally considered a complete or partial response, while a score above 0.45 indicates a poor or null response. Many clinicians use a threshold of 0.45 to decide whether to continue or stop corticosteroids.

Interpreting the Lille Score

The Lille score is not a diagnosis. It is a prognostic tool that helps guide treatment decisions in patients already diagnosed with severe alcoholic hepatitis (typically defined by a Maddrey's Discriminant Function ≥ 32).

• Lille < 0.45 — Response to corticosteroids. Continuing treatment is associated with improved six-month survival.
• Lille ≥ 0.45 — No response to corticosteroids. Continuing therapy is unlikely to provide benefit and may expose the patient to unnecessary side effects.

The score is most useful when interpreted alongside other clinical markers, including the patient's baseline MELD score, presence of infection, and overall clinical trajectory.

Common Clinical Use Cases

• Day 7 treatment evaluation — The Lille score is specifically designed for use after one week of corticosteroid therapy. It should not be used before treatment or at other time points.
• Early stopping rules — A high Lille score supports early discontinuation of steroids, reducing the risk of infection and other steroid-related complications.
• Prognostic stratification — The score helps identify patients who may benefit from alternative or salvage therapies, such as liver transplantation evaluation.

Limitations of the Lille Score

• The score is only validated for patients with severe alcoholic hepatitis who have received at least seven days of corticosteroids.
• It does not account for concurrent infections, gastrointestinal bleeding, or other acute complications that may affect bilirubin or renal function independently.
• Results should be interpreted by a clinician familiar with the patient's full clinical picture. The Lille score is a guide, not a definitive rule.
• Units for bilirubin and creatinine must be consistent. Conversion between µmol/L and mg/dL may introduce calculation errors if not handled carefully.