This calculator is for general information and education. It is not medical advice and does not replace the judgment of a doctor, nurse or pharmacist who knows the full clinical picture.
Alcoholic hepatitis and corticosteroids
Alcoholic hepatitis is an acute inflammation of the liver in people with heavy, long-term drinking. Severe forms, usually defined by a Maddrey discriminant function of 32 or more, carry a high risk of death within one to three months. Corticosteroids such as prednisolone 40 mg a day for 28 days improve short-term survival in some patients, but they also raise the risk of infection. The Lille model, developed at the Lille University Hospital in France and published in 2007, helps decide after one week whether the treatment is working.
The formula
R = 3.19 − 0.101 × age + 0.147 × albumin (g/L) + 0.0165 × (bilirubin day 0 − bilirubin day 7, µmol/L) − 0.206 × renal insufficiency − 0.0065 × bilirubin day 0 (µmol/L) − 0.0096 × prothrombin time (s)
Lille score = e^(−R) ÷ (1 + e^(−R))
Renal insufficiency counts as 1 when creatinine is above 1.3 mg/dL (115 µmol/L). The calculator converts albumin from g/dL and bilirubin from mg/dL (1 mg/dL = 17.1 µmol/L).
Interpretation
| Lille score | Meaning | Six-month survival in the original study |
|---|---|---|
| Below 0.45 | Response to corticosteroids | About 85% |
| 0.45 or more | Non-response | About 25% |
Later studies refined the result into complete responders (0.16 or less), partial responders (0.16 to 0.56) and null responders (0.56 or more).
Example
A 50-year-old patient with albumin 3.0 g/dL, bilirubin 11.7 mg/dL on day 0 falling to 8.8 mg/dL on day 7, normal creatinine and a prothrombin time of 18 seconds:
- Fall in bilirubin: about 25%
- R ≈ 1.895
- Lille score ≈ 0.131, a response; corticosteroids would usually be continued for the full 28 days.
What happens next
For responders, treatment continues to 28 days, with close monitoring for infection. For non-responders, stopping corticosteroids is usually discussed, and specialized centers may consider early liver transplantation for carefully selected patients. Lasting abstinence from alcohol is the most important factor for long-term survival in every case.
Limits
The score applies only to patients treated with corticosteroids for severe alcoholic hepatitis. It does not replace clinical judgment, the MELD score or the assessment of infections and kidney function by the hepatology team.