Lille Score Calculator - Day-7 Steroid Response for Severe Alcoholic Hepatitis

A Lille score calculator turns seven day-0 and day-7 blood markers plus the encephalopathy status into a 0-to-1 score used to grade how a patient with severe alcoholic hepatitis is responding to corticosteroid therapy. The Louvet 2007 model lets a clinician re-evaluate steroid continuation on day 7 against a published cut-off.

• • Day-7 steroid response check: Decide whether a patient with severe alcoholic hepatitis and a Maddrey discriminant function above 32 should keep prednisolone for the full 28-day course or stop early on non-response.
• • Hepatology clinic triage: Standardize the day-7 reassessment in a hepatology clinic so a nurse or trainee can compute the score the same way every visit.
• • Transplant center discussion: Use the result alongside MELD and Maddrey to flag null responders who may need early transplant evaluation.
• • Patient and family counseling: Show a number with a clear interpretation band so the conversation about continuing, switching, or stopping steroids is grounded in published thresholds.

The model sits between the Maddrey discriminant function, which decides whether to start steroids, and the MELD score, used for transplant listing. The cut-offs are < 0.45 for a complete responder, 0.45 to 0.56 for a partial responder, and >= 0.56 for a null responder.

When a hepatology workflow needs a second non-invasive liver screen alongside the Lille score for alcoholic hepatitis, the APRI Calculator turns AST and platelet count into the AST to Platelet Ratio Index using the WHO 2015 cut-offs, which keeps both tools in the same blood-test review.

The calculator combines seven inputs into one logistic regression and reads the result against the published 0.45 and 0.56 cut-offs.

• age: Patient age in years. Higher age subtracts 0.101 per year from P.
• albumin: Serum albumin in g/L. Each 1 g/L adds 0.147 to P, pulling toward the responder band.
• initialBilirubin: Day 0 bilirubin in mg/dL. Each 1 mg/dL subtracts 0.231 from P.
• day7Bilirubin: Day 7 bilirubin in mg/dL. The change (day 0 minus day 7) drives the response signal.
• inr: INR. Each 1.0 subtracts 0.266 from P, pushing toward the worse-outcome band.
• creatinine: Serum creatinine in mg/dL. Each 1.0 mg/dL adds 0.105 to P.
• encephalopathy: Hepatic encephalopathy at baseline: 0 = none, 1 = any grade. Subtracts 0.152 from P.

The bilirubin unit toggle is a practical detail. North American labs usually report bilirubin in mg/dL, while European and Asian labs report umol/L. The published regression uses mg/dL, so the calculator converts umol/L to mg/dL using 1 mg/dL = 17.1 umol/L. The creatinine toggle works the same way with 1 mg/dL = 88.4 umol/L.

According to MDCalc - Lille Model for Alcoholic Hepatitis, the published Lille regression coefficients and the 0.45 and 0.56 cutoffs

When a clinician needs a second non-invasive liver marker from the same admission blood draw to support a Lille score interpretation, the AST ALT Ratio Calculator turns AST and ALT into a single ratio and pairs naturally with the bilirubin-driven result.

Four concepts keep the model from being read as a black box and turn the result into a transparent clinical signal.

The interaction term (initial bilirubin times change) is what makes a small bilirubin drop at a very high baseline read differently from the same percentage drop at a lower baseline. The model is validated most often in prednisolone-treated patients, and EASL guidance also uses it for methylprednisolone and prednisone.

When the same hepatology admission also raises a heparin-induced thrombocytopenia concern because the platelet count is falling, the 4TS Score adds the four T categories of platelet fall, timing, thrombosis, and other causes into a 0 to 8 HIT pretest probability score that pairs with the Lille result on the same review.

The form runs on seven inputs that should already be on a steroid-day-7 hepatology review. Walk through the steps in order and read the result against the published cut-offs.

1. 1 Enter age and serum albumin: Type the patient's age in years and the most recent serum albumin in g/L.
2. 2 Enter day-0 and day-7 bilirubin in the picked unit: Use the bilirubin unit toggle to pick the unit that matches the lab report, then type the day-0 and day-7 total bilirubin values.
3. 3 Enter creatinine (with unit toggle) and INR: Type the most recent creatinine using the unit that matches the renal panel, and the most recent INR from the coagulation panel.
4. 4 Pick the encephalopathy status: Choose 'None' or 'Any grade' based on the day-7 clinical exam. Any grade from 1 to 4 counts as yes.
5. 5 Read the score and pair it with the published bands: Read the result on the right panel and the responder label, then compare the score against the < 0.45, 0.45 to 0.56, and >= 0.56 bands.

A 50-year-old patient with alcoholic hepatitis starts prednisolone. Day-0 bilirubin 12 mg/dL, day-7 bilirubin 6 mg/dL, albumin 28 g/L, INR 1.6, creatinine 1.0 mg/dL, no encephalopathy. The calculator returns 0.677 and a 'Null responder' label, which pairs with EASL guidance on stopping steroids.

When a day-7 review also needs a kidney function number, the GFR Calculator turns serum creatinine, age, and gender into an estimated GFR using the CKD-EPI equation, which is a useful second check because creatinine appears in both the Lille and the eGFR formulas.

Using a published calculator alongside the day-7 hepatology review brings the steroid stop-or-continue decision to a single number with a clear interpretation band.

• • Built on the published Louvet coefficients: The same regression coefficients and cut-offs as the MDCalc reproduction of the Louvet 2007 model.
• • Unit toggles for bilirubin and creatinine: A bilirubin toggle between mg/dL and umol/L and a creatinine toggle between mg/dL and umol/L mean the form works in North American, European, and Asian labs.
• • Day-0 minus day-7 change in bilirubin: The form subtracts the day-7 bilirubin from the day-0 bilirubin automatically, so the user does not have to pre-compute the change by hand.
• • Responder label with linear predictor cross-check: The right panel shows the score, the linear predictor P, the change in bilirubin, and a complete / partial / null responder label.
• • Pairs with the EASL steroid guidance: The 0.45 and 0.56 cut-offs match the EASL clinical practice guideline on alcohol-related liver disease, so the answer can be dropped into a steroid continuation discussion.

The score is a planning tool, not a stand-alone treatment recommendation. EASL guidance says the result should be used alongside the patient's clinical trajectory. Stopping steroids is one of several options in the null-responder band, not an automatic switch.

For hepatology admissions that cross over into the post-anesthesia or post-procedure setting, the Aldrete Score Calculator scores recovery room readiness on activity, respiration, circulation, consciousness, and color, which is a useful companion to a Lille score on a transplant pathway.

Four factors move the score the most. Knowing them keeps the result from being read alone.

• • The model was derived in patients with severe alcoholic hepatitis and a Maddrey discriminant function above 32 treated with corticosteroids. It has not been validated in non-alcoholic steatohepatitis, in pentoxifylline-only treatment, or in active infection or gastrointestinal bleeding on admission.
• • The score is calculated on day 7 and is not designed for serial use before that. An earlier score risks a false null-responder reading because bilirubin is still falling.
• • The score is a probability, not a treatment. EASL guidance uses it to support a steroid continuation discussion, not to mandate a switch.

A Lille reading should be reviewed alongside the Maddrey discriminant function, the MELD score, and the trend in encephalopathy, and re-checked after the next labs.

According to EASL CPG on alcohol-related liver disease, the Lille score should be calculated on day 7 of corticosteroid therapy to identify non-responders

According to Omni Calculator - Lille Score, the standard input set of age, bilirubin day 0 and day 7, albumin, creatinine, INR, and encephalopathy with the published cutoffs

When the same hepatology review also needs a fasting lipid panel read for cardiovascular risk, the LDL Calculator turns total cholesterol, HDL, and triglycerides into a Friedewald LDL value, which is a useful second test on the day-7 blood draw.