Lille Score Calculator
Calculate the Lille score for alcoholic hepatitis prognosis using the validated Lille model. Enter age, PT, albumin, creatinine, and bilirubin values to predict 6-month survival and steroid therapy response.
About This Calculator
The Lille Score Calculator is a free online tool for healthcare professionals and patients to calculate the Lille score, a clinically validated prognostic model for severe alcoholic hepatitis. This scoring system helps predict 6-month survival and determine whether a patient is responding to corticosteroid therapy, guiding critical treatment decisions such as whether to continue or discontinue steroids.
The Lille model was developed by Louvet et al. and published in 2007. It combines six clinical and laboratory variables measured at the start of therapy (day 0) and on day 7 of treatment. The variables include patient age, prothrombin time (PT), serum albumin, serum creatinine (which determines renal insufficiency status), and total bilirubin at both day 0 and day 7. The model uses logistic regression to compute a score between 0 and 1, where lower scores indicate better prognosis and higher likelihood of response to steroids.
The formula involves two steps. First, the R value (logit) is calculated: R = 3.19 − (0.101 × Age) + (0.147 × Albumin in g/L) + (0.0165 × change in bilirubin in µmol/L) − (0.206 × renal insufficiency) − (0.0065 × bilirubin day 0 in µmol/L) − (0.0096 × PT in seconds). Renal insufficiency is present when serum creatinine exceeds 1.3 mg/dL. The final Lille score is derived as exp(−R) / (1 + exp(−R)).
A Lille score below 0.16 indicates excellent prognosis with over 90% 6-month survival. Scores between 0.16 and 0.45 suggest good response to steroids with approximately 85% survival. Scores of 0.45 and above identify non-responders — patients unlikely to benefit from continued steroid therapy. Scores exceeding 0.56 carry a particularly poor prognosis with only about 25% 6-month survival, and most clinical guidelines recommend stopping steroids in these patients.
Clinical Application
The Lille score is primarily used in hepatology and gastroenterology departments for managing patients with severe alcoholic hepatitis. It is applied on day 7 of a 28-day corticosteroid course. The score complements other liver disease severity scores such as the Maddrey's discriminant function (DF), MELD score, and Child-Pugh score, each serving a different purpose in the clinical assessment of liver disease.
This calculator is intended for educational and clinical reference purposes. Results should always be interpreted by a qualified healthcare professional in the context of the patient's complete clinical presentation. Never make treatment decisions based solely on this calculator's output.
Regional Availability
The Lille score is a globally accepted clinical tool used in hepatology centers across India, the United States, the United Kingdom, Europe, and worldwide. The laboratory units used in this calculator (mg/dL for bilirubin and creatinine, g/dL for albumin) are standard in most clinical laboratories. Users in countries using SI units (µmol/L for bilirubin, mmol/L for creatinine, g/L for albumin) can use conversion factors: bilirubin 1 mg/dL = 17.1 µmol/L, creatinine 1 mg/dL = 88.4 µmol/L, albumin 1 g/dL = 10 g/L.
Frequently Asked Questions
What is the Lille score used for?
The Lille score is a validated clinical prediction model used to assess prognosis in patients with severe alcoholic hepatitis who are receiving corticosteroid therapy. It predicts 6-month survival and helps determine whether to continue or discontinue steroid treatment based on the patient's likelihood of response.
What is a good Lille score?
A Lille score below 0.45 indicates a good prognosis with likely response to steroid therapy. Scores between 0.16 and 0.45 suggest good response with approximately 85% 6-month survival. Scores below 0.16 indicate excellent prognosis with over 90% survival. Scores above 0.56 indicate poor prognosis and steroid therapy may be discontinued.
What inputs are needed for the Lille score calculation?
The Lille score requires six clinical parameters: patient age in years, prothrombin time (PT) in seconds, serum albumin in g/dL, serum creatinine in mg/dL, and total bilirubin in mg/dL measured on day 0 (start of steroid therapy) and day 7 of treatment. Renal insufficiency is determined from the creatinine value (more than 1.3 mg/dL indicates renal impairment).
How is the Lille score interpreted?
The Lille score ranges from 0 to 1. A score below 0.45 identifies steroid responders with good prognosis, while a score of 0.45 or higher indicates non-response with poor outcomes. Scores above 0.56 suggest very poor prognosis with only about 25% 6-month survival, and discontinuation of steroids is typically recommended.
What is the Lille model formula?
The Lille score is calculated using a two-step formula. First, the R value is computed: R = 3.19 − (0.101 × Age) + (0.147 × Albumin in g/L) + (0.0165 × (Bilirubin day 7 − Bilirubin day 0) in µmol/L) − (0.206 × Renal insufficiency) − (0.0065 × Bilirubin day 0 in µmol/L) − (0.0096 × PT in seconds). Then the Lille score = exp(−R) / (1 + exp(−R)). Renal insufficiency is defined as creatinine > 1.3 mg/dL.
Can the Lille score be used for all hepatitis patients?
No, the Lille score is specifically designed for patients with severe alcoholic hepatitis who have been started on corticosteroid therapy. It is not intended for other forms of hepatitis or liver disease. Other scoring systems like Child-Pugh or MELD are used for broader liver disease assessment.
How accurate is the Lille score for predicting survival?
The Lille score is well-validated in clinical studies for predicting 6-month survival in alcoholic hepatitis patients on steroids. Patients with scores below 0.45 have approximately 85% 6-month survival, while those above 0.56 have only about 25% survival. The score should be used alongside clinical judgment and other diagnostic information.
Should I stop steroids based on a high Lille score?
A Lille score above 0.45 at day 7 of steroid therapy suggests the patient is unlikely to benefit from continued steroids. Many clinical guidelines recommend considering discontinuation of steroids in non-responders (Lille score ≥ 0.45) due to the lack of therapeutic benefit and risk of adverse effects. This decision should always be made by the treating physician based on the full clinical picture.