Lille Model Calculator
Lille Model Calculator
Decide at day 7 whether corticosteroids are working in severe alcohol-related hepatitis, using the change in bilirubin.
Lille Model
Day 0 + day 7Age 48, albumin 28 g/L, bilirubin 205 → 150 µmol/L, PT 19.5 s, no renal impairment
Formula
Lille = e^(−R) ÷ (1 + e^(−R))
- albumin
- g/L at day 0
- Δbilirubin
- day 0 minus day 7, in µmol/L — a positive value means bilirubin fell
- renal
- 1 if creatinine above 115 µmol/L (1.3 mg/dL), otherwise 0
- PT
- prothrombin time in seconds
Worked example
Age 48, albumin 28 g/L, bilirubin 205 → 150 µmol/L, PT 19.5 s, no renal impairment
R = 3.19 − (0.101×48) + (0.147×28) + (0.0165×55) − 0 − (0.0065×205) − (0.0096×19.5)
R = 3.19 − 4.848 + 4.116 + 0.9075 − 1.3325 − 0.1872 = 1.846
Lille = e^(−1.846) ÷ (1 + e^(−1.846)) = 0.136
Below 0.45 → responder, continue corticosteroids
Interpretation at day 7
| Lille score | Response | 6-month survival | Action |
|---|---|---|---|
| < 0.45 | Responder | ≈ 85% | Complete the 28-day steroid course |
| ≥ 0.45 | Non-responder | ≈ 25% | Stop steroids; consider early transplant assessment |
What the Lille model is for
Corticosteroids help some patients with severe alcohol-related hepatitis and not others, and continuing them in a non-responder adds infection risk without benefit. The Lille model was built to make that call at day 7, early enough to change management.
The dominant term is the fall in bilirubin over the first week. A patient whose bilirubin is coming down is responding, and the other variables — age, albumin, prothrombin time and renal function — adjust for baseline severity. The logistic transformation produces a probability-like number between 0 and 1, where higher means worse.
The 0.45 cut-off separates two very different trajectories: roughly 85% six-month survival below it against roughly 25% above. That gap is what makes the score actionable. In a non-responder, stopping steroids avoids further immunosuppression, and it opens the question of early liver transplantation, which in carefully selected patients with a first episode and strong psychosocial support has shown survival benefit in several European and North American series.
The score requires a day 7 bilirubin, so it cannot be calculated at admission. Its inputs are also specified in SI units — albumin in g/L and bilirubin in µmol/L — and using conventional units gives a meaningless result.
Frequently asked questions
When is the Lille score calculated?
On day 7 of corticosteroid treatment for severe alcohol-related hepatitis. It compares bilirubin at day 7 with the value at day 0, so it cannot be calculated on admission.
What Lille score means treatment is failing?
0.45 or above indicates non-response. Corticosteroids should be stopped, and early liver transplantation considered in carefully selected patients.
Which units does the Lille model use?
Albumin in g/L, bilirubin in µmol/L and prothrombin time in seconds. Multiply g/dL albumin by 10 and mg/dL bilirubin by 17.1 before entering them.
What does renal insufficiency mean in this score?
A creatinine above 115 µmol/L, equivalent to 1.3 mg/dL, at the time of assessment. It scores 1; otherwise 0.
Related calculators
References
- Louvet A et al. The Lille model: a new tool for therapeutic strategy in patients with severe alcoholic hepatitis treated with steroids. Hepatology. 2007;45(6):1348–54.
- Crabb DW et al. Diagnosis and treatment of alcohol-associated liver diseases: AASLD practice guidance. Hepatology. 2020;71(1):306–33.
Medical Disclaimer: The tools and content provided here are for educational and reference purposes only. They are not intended to substitute for professional medical advice, diagnosis, or treatment. Clinical decisions should always be based on the comprehensive assessment of a qualified healthcare professional.