Lille Score - Steroid Response in Alcoholic Hepatitis
Predict 6-month survival and guide steroid therapy decisions after 7 days of prednisolone. Validated model for severe alcoholic hepatitis (Maddrey DF ≥ 32).
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<0.16: Continue steroids, ~90% survival 0.16-0.45: Partial responder, monitor closely ≥0.45: Stop steroids, transplant evaluation
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Why: Early identification of non-responders allows timely transplant evaluation and avoids futile steroid therapy.
How: Uses age, albumin, bilirubin change (Day 0→7), creatinine, and PT. Lille < 0.16: complete responder; ≥ 0.45: null responder.
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✅ Complete Responder
Excellent bilirubin decrease, good prognosis
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⚠️ Partial Responder
Moderate bilirubin response
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❌ Null Responder
Poor response, high mortality
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🏥 Severe AH
High DF score with complications
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🔬 Renal Involvement
Hepatorenal syndrome concern
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For informational purposes only — not medical advice. Consult a healthcare professional before acting on results.
🏥 Health Facts
Lille calculated at Day 7 of steroid therapy. Bilirubin change is the key prognostic variable.
— Loupien 2007
Understanding the Lille Score
The Lille Score is a validated prognostic model developed to predict response to corticosteroid therapy in severe alcoholic hepatitis. It is calculated after 7 days of prednisolone treatment to guide ongoing therapy decisions.
Responders (Lille < 0.45)
Good prognosis
- • 70-90% 6-month survival
- • Continue full steroid course
- • Bilirubin decreasing
- • Medical management effective
Non-Responders (Lille ≥ 0.45)
Poor prognosis
- • 25-40% 6-month survival
- • Consider stopping steroids
- • Early transplant evaluation
- • Goals of care discussion
Key Variables in Lille Score
Bilirubin Change
Day 0 to Day 7 - Most important variable for steroid response assessment
Renal Function
Creatinine ≥ 1.3 mg/dL indicates renal insufficiency (worse prognosis)
Coagulation
PT/INR reflects synthetic function and disease severity
When to Calculate Lille Score
Day 7 of Steroid Therapy
Calculate after exactly 7 days of prednisolone (40mg/day) or equivalent
Severe Alcoholic Hepatitis
Patients with Maddrey DF ≥ 32 who received steroids
Treatment Decision Point
To decide whether to continue or stop corticosteroid therapy
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