Lille Score Calculator
Corticosteroid response in severe alcoholic hepatitis — the Lille model (Louvet et al., Hepatology 2007), with day 4 and day 7 variants and automatic unit conversion.
Calculate the Lille score
Your Lille score
How the score was computed
| Term | Value used | Contribution |
|---|---|---|
| R (sum) | – | |
Lille = exp(−R) / (1 + exp(−R)). A falling bilirubin (day 0 → day 4/7) raises R and lowers the score.
The formula (Louvet et al., Hepatology 2007)
R = 3.19 − 0.101 × age + 0.147 × albuminday0 + 0.0165 × (bilirubinday0 − bilirubinday4/7) − 0.206 × renal insufficiency − 0.0065 × bilirubinday0 − 0.0096 × PT
Lille = exp(−R) / (1 + exp(−R)) — a probability from 0 to 1.
Cutoff: Lille > 0.45 = non-responder · Lille ≤ 0.45 = responder. Published sub-bands: 0.45–0.56 partial responder, ≥ 0.56 null responder (poorest survival).
What each variable means
Age
Age in years at treatment start. The formula subtracts 0.101 × age from R, so older age lowers R and raises the Lille score (worse predicted response).
Albumin (day 0)
Serum albumin before steroids, in g/L. Higher albumin (better liver synthetic function) raises R and lowers the score.
Bilirubin evolution
Bilirubin day 0 minus bilirubin day 4/7, in µmol/L. A falling bilirubin gives a positive evolution, raising R and lowering the score — early improvement predicts response.
Renal insufficiency
Coded 1 if present, 0 if absent. Defined as creatinine > 1.3 mg/dL (115 µmol/L) or creatinine clearance < 40 ml/min. Presence subtracts 0.206 from R, raising the score.
Baseline bilirubin
Total bilirubin at day 0, in µmol/L. Higher baseline bilirubin lowers R and raises the score.
Prothrombin time
PT in seconds (not INR). A more prolonged PT lowers R and raises the score — each extra second subtracts 0.0096 from R.
What the Lille score does NOT replace
The Lille score answers one question: is this patient responding to corticosteroids? It is measured after steroids have started. Related liver scores answer different questions:
- Maddrey discriminant function — severity at admission in alcoholic hepatitis; identifies who may be considered for steroids (threshold 32).
- Child-Pugh — grades chronic cirrhosis severity from five parameters (bilirubin, albumin, INR, ascites, encephalopathy).
- MELD — estimates short-term mortality for transplant allocation.
- FIB-4 / APRI — simple fibrosis screening scores, not treatment-response models.
Frequently asked questions
What is the Lille score?
The Lille score (Louvet et al., Hepatology 2007) is a published clinical model that estimates the response to corticosteroid treatment in severe alcoholic hepatitis. It combines six objective variables — age, albumin at day 0, the change in bilirubin between day 0 and day 4 or 7, renal insufficiency, baseline bilirubin, and prothrombin time — into a probability between 0 and 1. This calculator is a free online educational implementation of that model.
What is the Lille score formula?
The published formula is R = 3.19 − 0.101 × age(years) + 0.147 × albumin day 0 (g/L) + 0.0165 × (bilirubin day 0 − bilirubin day 4/7, in µmol/L) − 0.206 × renal insufficiency (0 or 1) − 0.0065 × bilirubin day 0 (µmol/L) − 0.0096 × prothrombin time (seconds), and Lille = exp(−R) / (1 + exp(−R)). This calculator shows the value of R and each term so you can verify the arithmetic.
What does a Lille score above 0.45 mean?
In the published model, a Lille score above 0.45 classifies a patient as a non-responder to corticosteroids, while 0.45 or below classifies them as a responder. In the original study, patients above 0.45 had about 75% six-month mortality versus about 15% below 0.45. The 0.45 cutoff is a statistical classification from the model, not a treatment order — whether to continue or stop steroids is a decision for the treating physician, so discuss the result with them.
What bilirubin units does this Lille calculator use?
The formula expects total bilirubin in µmol/L. If your lab reports bilirubin in mg/dL, multiply by 17.1 to convert — for example, 17.5 mg/dL equals about 299 µmol/L. This calculator accepts both units and converts automatically; the converted values used in the formula are shown with the result.
Should the Lille score be calculated on day 4 or day 7?
The original Lille model was developed with bilirubin measured on day 7 of corticosteroid treatment, but later studies validated a day-4 version with similar prognostic value, which allows an earlier assessment. This calculator lets you choose day 4 or day 7 for the second bilirubin measurement; the same published formula and the 0.45 cutoff are used in both cases.
What counts as renal insufficiency in the Lille model?
In the original Lille model, renal insufficiency is coded as 1 if present and 0 if absent, defined as serum creatinine above 1.3 mg/dL (115 µmol/L) or creatinine clearance below 40 ml/min. If neither criterion is met, select No (0).
Can I use INR instead of prothrombin time in seconds?
The published Lille formula was calibrated on prothrombin time in seconds, so PT in seconds is the correct input. INR is a standardized ratio and is not interchangeable with PT seconds in this equation. If your lab report only shows INR, ask the laboratory for the PT value in seconds.
What is the difference between complete, partial, and null responders?
Beyond the main 0.45 cutoff, published literature further describes response bands: a Lille score of 0.45 or below is a complete responder, 0.45 to 0.56 a partial responder with intermediate outcomes, and 0.56 or above a null responder with the poorest survival. These bands are descriptive context from published studies, not separate treatment rules, and clinical decisions should be discussed with the treating physician.
How does the Lille score differ from the Maddrey discriminant function, Child-Pugh, and MELD?
They answer different clinical questions. The Maddrey discriminant function estimates severity at admission in alcoholic hepatitis (steroid indication, threshold 32). The Lille score is measured after steroids have started and estimates response to that treatment. Child-Pugh grades chronic cirrhosis severity from five parameters, and MELD estimates mortality for transplant allocation. They cannot replace each other.
Is the Lille score a diagnosis?
No. The Lille score is a response-prediction model for patients already diagnosed with severe alcoholic hepatitis and started on corticosteroids; it does not diagnose liver disease. It is an educational estimate based on a published statistical model, not medical advice, and treatment decisions must be made by a qualified physician.
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