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21
MELD-NaAssesses the severity of chronic liver diseaseChild-Pugh ScoreAssesses the prognosis of chronic liver disease, mainly cirrhosisFIB-4 IndexLiver fibrosis scoring indexAPRIAST to platelet ratio — liver fibrosisMaddrey's DFAlcoholic hepatitis severityGlasgow-BlatchfordUpper GI bleed risk stratificationGAHSGlasgow alcoholic hepatitis scoreMontreal IBDIBD classification — CD & UCMayo ScoreUlcerative colitis activityBISAP ScoreBedside index for severity of pancreatitisCLIF-SOFAOrgan failure scoring in cirrhosisAlcohol ContentStandard drinks & alcohol grams calculatorAARC-ACLFAcute-on-chronic liver failure gradePELD / CR ScorePediatric end-stage liver diseaseHarvey-BradshawCrohn's disease activity indexCTSICT severity index — pancreatitisRockall ScoreGI bleed rebleeding & mortality riskCAGEAlcohol use disorder screening (4 questions)MELD 3.0Updated MELD — sex-inclusive formulaAUDIT ScoreAlcohol use disorders identification testVOCAL-Penn ScorePost-operative mortality risk in cirrhosis surgery

Liver & Cirrhosis

17
ALBI GradeAlbumin-bilirubin liver function grade in HCCUKELD ScoreUK model for end-stage liver diseaseMELD-XIMELD excluding INR — for anticoagulated patientsWest Haven CriteriaHepatic encephalopathy gradingMilan CriteriaLiver transplant eligibility in hepatocellular carcinomaLI-RADS v2018 (CT/MRI)Liver observation category from size, APHE and major featuresBCLC StagingHepatocellular carcinoma stage and treatment allocationSimplified AIH CriteriaSimplified criteria for autoimmune hepatitisRevised Original AIH ScoreIAIHG 1999 comprehensive autoimmune hepatitis scoreSAAGSerum-ascites albumin gradient — cause of ascitesR FactorHepatocellular vs cholestatic pattern in liver injuryCLIF-C ACLFMortality prediction in acute-on-chronic liver failureKing's College CriteriaTransplant criteria in acute liver failureGALAD ScoreHCC detection from gender, age, AFP-L3, AFP and DCPMetroticket 2.0AFP-adjusted up-to-seven for HCC transplant eligibilityRUCAMCausality in drug- and herb-induced liver injuryBaveno VII CriteriacACLD, CSPH and sparing screening endoscopy

Fibrosis & MASLD

8
NAFLD Fibrosis ScoreAdvanced fibrosis probability in MASLD/NAFLDBARD ScoreBMI, AST/ALT ratio, diabetes — MASLD fibrosisFatty Liver IndexPredicts hepatic steatosis from routine labsFibrotic NASH Index (FNI)At-risk NASH probability from AST, HbA1c and HDLNAFLD Activity Score (NAS)Histologic activity grade — steatosis, inflammation, ballooningMEFIB IndexMRE + FIB-4 rule for significant fibrosis (≥F2) in MASLDFAST ScoreFibroScan-AST — at-risk NASH from LSM, CAP and ASTSAFE ScoreSteatosis-Associated Fibrosis Estimator for MASLD in primary care

Pancreas & Biliary

8
Ranson's CriteriaAcute pancreatitis severity at 48 hoursGlasgow-Imrie CriteriaAcute pancreatitis severity — the PANCREAS criteriaHAPSHarmless acute pancreatitis scoreTokyo Guidelines — CholangitisTG18 diagnosis and severity grade for acute cholangitisTokyo Guidelines — CholecystitisTG18 diagnosis and severity grade for acute cholecystitisBiliary Pain (Rome IV)Rome IV — defining biliary-type pain before interventionFunctional Pancreatic SODRome IV — pancreatic sphincter of Oddi disorderRevised Atlanta ClassificationAcute pancreatitis severity — mild, moderately severe, severe

IBD

9
Truelove & Witts CriteriaAcute severe ulcerative colitis — admission decisionUCEISUlcerative colitis endoscopic index of severitySCCAISimple clinical colitis activity index — symptoms onlyCDAICrohn's disease activity index — the trial standardSES-CDEndoscopic severity in Crohn's diseasePUCAIPaediatric ulcerative colitis activity indexTravis (Oxford) CriteriaDay 3 colectomy risk in acute severe ulcerative colitisHo IndexDay 3 steroid failure risk in acute severe ulcerative colitisRutgeerts ScorePostoperative Crohn's recurrence at ileocolonoscopy

GI Bleeding

7
EVendo ScorePredicts oesophageal varices needing treatmentForrest ClassificationPeptic ulcer bleeding — rebleeding risk at endoscopyAIMS65 ScoreUpper GI bleed mortality — five bedside criteriaOakland ScoreSafe-discharge risk for acute lower GI bleedingABC ScoreAge, blood tests, comorbidities — GI bleed mortalitySarin ClassificationEndoscopic classification of gastric varicesEGUS (Gastric Ulcer)Malignancy risk in a gastric ulcer, and who needs repeat endoscopy

Alcohol

2
ABIC ScoreAge, bilirubin, INR, creatinine — alcoholic hepatitisLille ModelSteroid response at day 7 in alcoholic hepatitis

Upper GI

4
Chicago Classification v4.0Oesophageal motility pattern from high-resolution manometryLA Classification (Oesophagitis)Los Angeles grade A–D for erosive oesophagitisPrague C & M CriteriaCircumferential and maximal extent of Barrett's oesophagusEREFS (Eosinophilic Oesophagitis)Endoscopic reference score — oedema, rings, exudates, furrows, stricture

Colorectal

3
Boston Bowel Prep ScaleColonoscopy preparation adequacy by segmentStool Osmotic GapOsmotic vs secretory diarrhoea from stool electrolytesATLAS Score (C. difficile)Predicted response to therapy in Clostridioides difficile infection

Functional GI

37
Bristol Stool ScaleStool form types 1–7 and colonic transitRome IV Criteria for IBSIrritable bowel syndrome diagnosis and subtypeFunctional ConstipationRome IV — two of six items, IBS excludedOpioid-Induced ConstipationRome IV — constipation tied to opioid therapyFunctional DiarrhoeaRome IV — loose stools without predominant painFunctional Bloating / DistensionRome IV — bloating without other bowel disorder criteriaUnspecified Functional Bowel DisorderRome IV — bowel symptoms fitting no other categoryCentrally Mediated Abdominal Pain (CAPS)Rome IV — continuous pain unrelated to gut eventsNarcotic Bowel SyndromeRome IV — opioid-induced hyperalgesia of the gutFaecal Incontinence (Rome IV)Rome IV — the criteria, and why nobody is askedFunctional Anorectal PainLevator ani, unspecified pain and proctalgia fugaxFunctional Defecation DisordersRome IV — dyssynergia and inadequate propulsionInfant RegurgitationRome IV — the happy spitter, and the alarm features that rule it outInfant ColicRome IV — recurrent unexplained crying in a well infant under 5 monthsInfant DyscheziaRome IV — straining before a soft stool, and why not to intervenePaediatric Functional ConstipationRome IV — two of six over one month, with overflow soiling as a criterionToddler's DiarrhoeaRome IV functional diarrhoea of childhood — painless, thriving childPaediatric Cyclic Vomiting SyndromeRome IV — both age bands, with different criteria for eachPaediatric Rumination SyndromeRome IV — infant and child/adolescent criteriaFunctional Nausea & Vomiting (Children)Rome IV — two separate disorders that can be met togetherAerophagiaRome IV — distension that increases through the dayPaediatric Functional DyspepsiaRome IV — four times a month, with PDS and EPS subtypingPaediatric Irritable Bowel SyndromeRome IV — plus the constipation clause clinicians missAbdominal MigraineRome IV — stereotypical incapacitating episodes weeks apartFunctional Abdominal Pain — NOSRome IV — the residual category, reached after the other threeNonretentive Faecal IncontinenceRome IV — soiling without retention, where laxatives make it worseFunctional DyspepsiaRome IV — with PDS and EPS subtypingRumination SyndromeRome IV — effortless regurgitation without retchingCyclic Vomiting SyndromeRome IV — stereotypical episodic vomitingCannabinoid HyperemesisRome IV — CVS pattern relieved by cannabis cessationChronic Nausea & VomitingRome IV — chronic nausea and vomiting syndromeBelching DisordersRome IV — supragastric vs gastric belchingFunctional HeartburnRome IV — heartburn with normal acid exposureReflux HypersensitivityRome IV — normal acid exposure, positive symptom associationFunctional Chest PainRome IV — non-cardiac, non-reflux chest painGlobusRome IV — painless lump-in-throat sensationFunctional DysphagiaRome IV — dysphagia with normal endoscopy and manometry
  1. Calculators
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  3. Lille Model
Alcohol

Lille Model

Steroid response at day 7 in alcoholic hepatitis

Assesses corticosteroid response after 7 days of treatment, so it needs both the day-0 and day-7 bilirubin. Renal insufficiency is taken as creatinine > 1.3 mg/dL.

When to use
Calculate the Lille score on day 7 in a patient with severe alcohol-related hepatitis — a Maddrey discriminant function of 32 or above — who has been started on corticosteroids. It is the tool that converts a treatment trial into a decision: continue steroids in responders, and in non-responders stop them and turn to alternatives, which in practice means considering early transplant assessment in selected patients and otherwise focusing on supportive care and abstinence. It requires both the day-0 and the day-7 bilirubin, so the day-0 value must be recorded prospectively when treatment starts; if it was not, the score cannot be reconstructed. It has no role at admission, in untreated patients, or as a severity score in its own right.
Why use it
Because before this model 'non-responder' had no operational definition, and steroids were often continued for a full course regardless of whether they were achieving anything. That matters more than it would for a benign drug: corticosteroids in this population carry real infection risk, and a patient with deepening jaundice and no biochemical response is accumulating harm without benefit. Louvet and colleagues showed that a week is long enough to tell — the trajectory of bilirubin over seven days, combined with five baseline variables, separated survivors from non-survivors at six months with enough precision to justify stopping treatment. It also created something the field lacked: a reproducible entry criterion for trials of salvage therapy.
Formula, evidence and interpretation

About the Lille Model for Corticosteroid Response in Alcohol-Related Hepatitis

Unlike every other alcohol-related hepatitis score, the Lille model is calculated after seven days of corticosteroid treatment rather than at admission — it exists to answer a question no baseline score can, which is whether the steroids are working. It combines five admission variables (age, albumin, prothrombin time, renal insufficiency and day-0 bilirubin) with the one dynamic term that carries the model: how far bilirubin has fallen by day 7. A score of 0.45 or above defines a non-responder, which described about 40% of treated patients in the derivation work and predicts roughly 25% six-month survival, against about 85% for those scoring below 0.45. Because prolonging ineffective immunosuppression in a jaundiced, infection-prone patient does harm, identifying non-response early is the point.

On this page

  • Formula
  • Interpreting the result
  • Inputs
  • What it returns
  • How it is calculated
  • Facts & figures
  • Evidence
  • How it compares
  • Pearls & pitfalls
  • Critical actions
  • Why it exists
  • About the creator
  • Limitations
  • If you are the patient
  • FAQ
  • Related calculators
  • References

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))
age
In years.
albumin
Day-0 albumin in g/L (multiply g/dL by 10).
Δ bilirubin
The FALL in bilirubin from day 0 to day 7 in µmol/L, so a decrease is a positive number. A rising bilirubin makes this term negative and drives the score up.
renal insufficiency
1 if creatinine exceeds 1.3 mg/dL (about 115 µmol/L), otherwise 0.
bilirubin day 0
Baseline bilirubin in µmol/L, entering with a negative coefficient.
prothrombin time
In seconds, not INR.
  • The published model uses SI units — albumin in g/L and bilirubin in µmol/L. Feeding mg/dL and g/dL values into these coefficients gives a meaningless score.
  • The bilirubin term is the FALL from day 0 to day 7. Getting the sign backwards inverts the model's central variable and will misclassify responders as non-responders.
  • Prothrombin time is in seconds. Substituting INR is a common and consequential error, since the two are on entirely different scales.
  • Renal insufficiency is dichotomised at a creatinine of 1.3 mg/dL rather than entered continuously, so a creatinine of 1.4 and one of 4.0 contribute identically.
  • The final logistic transformation constrains the output to between 0 and 1, which is why the score reads as a probability rather than a points total.

Interpreting the result

A score below 0.45 marks a responder, with roughly 85% six-month survival, and continuing the corticosteroid course is generally appropriate. A score of 0.45 or above defines non-response — around 40% of treated patients in the derivation cohort — and predicts approximately 25% six-month survival. In that group the reasoning shifts: continuing steroids is not merely futile but actively harmful given the infection risk they carry in a patient who is already immunocompromised by liver failure, so the accepted course is to stop them. What follows depends on the individual — early liver transplantation has become an option for carefully selected non-responders, and where it is not appropriate the emphasis moves to supportive care, infection control, nutrition, abstinence support and honest prognostic discussion. Combining Lille with a static baseline score such as ABIC or MELD predicts survival better than either approach used alone.

ScoreBandWhat it meansAction
< 0.45Steroid responderApproximately 85% six-month survivalContinue the corticosteroid course; maintain infection surveillance, nutrition and abstinence support
≥ 0.45Steroid non-responderApproximately 25% six-month survival; about 40% of treated patients fall hereStop corticosteroids; consider early transplant assessment in selected patients, and otherwise focus on supportive care and prognostic discussion

What the Lille Model needs (6 inputs)

Age (years)
Enters with a negative coefficient in the linear predictor R.
Albumin, day 0 (g/dL)
Baseline albumin, converted to g/L for the published formula.
Total bilirubin, day 0 (mg/dL)
The baseline value, used both on its own and to calculate the fall by day 7.
Total bilirubin, day 7 (mg/dL)
The value after a week of corticosteroids. The difference from day 0 is the dynamic term that gives the model its power.
Prothrombin time (seconds)
Baseline prothrombin time in seconds, not INR — the model was published in seconds.
Creatinine (mg/dL)
Used as a binary term: renal insufficiency is defined as a creatinine above 1.3 mg/dL, which contributes a fixed amount.

Units. The Lille model is an SI-unit formula: albumin in g/L, bilirubin in µmol/L, prothrombin time in seconds. Convert with albumin g/dL × 10 = g/L and bilirubin mg/dL × 17.1 = µmol/L. Renal insufficiency is defined at creatinine > 1.3 mg/dL (≈ 115 µmol/L). This calculator accepts conventional units and converts internally.

What it returns

Lille score
A probability between 0 and 1. Higher values indicate a poorer response to corticosteroids.
Response category
Responder (below 0.45) or non-responder (0.45 or above).

How it is calculated

The model was built on 320 patients with severe alcohol-related hepatitis — defined by a discriminant function of 32 or above — prospectively treated with corticosteroids, with a further 118 used for validation. Baseline data and the change in bilirubin at day 7 were tested by logistic regression against death at six months. Six reproducible variables survived: age, renal insufficiency, albumin, prothrombin time, day-0 bilirubin, and the evolution of bilirubin at day 7. The structure is worth noticing — five of the six are baseline measurements, and only one describes what has happened during treatment, yet it is that single dynamic term that turns a prognostic model into a treatment-response model. The linear predictor is then passed through a logistic function so the result is expressed as a probability of poor outcome.

Facts & figures

Lille score and six-month survival
Lille scoreCategorySix-month survivalProportion of patients
< 0.45Responder≈ 85%≈ 60%
≥ 0.45Non-responder≈ 25%≈ 40%

Derived in 320 corticosteroid-treated patients with a discriminant function ≥ 32, validated in a further 118.

Static versus dynamic scoring in alcohol-related hepatitis
Static scores (Maddrey, MELD, ABIC, GAHS)Lille model
TimingAdmissionDay 7 of corticosteroids
Question answeredHow severe is this, and who should be treated?Is the treatment working?
Requires a repeat bilirubinNoYes — day 0 and day 7
Applies to untreated patientsYesNo

Joint-effect models pairing a static score with Lille outperformed either alone for two- and six-month survival (derivation n = 538, validation n = 604).

Evidence

Derivation — Louvet

2007 · n = 320

320 patients with severe alcohol-related hepatitis (discriminant function ≥ 32) prospectively treated with corticosteroids, forming the development cohort, with 118 further patients used for validation. Baseline variables and the change in bilirubin at day 7 were entered into a logistic regression predicting death at six months.

A model combining six reproducible variables — age, renal insufficiency, albumin, prothrombin time, bilirubin and the evolution of bilirubin at day 7 — was highly predictive of death at six months. A score above 0.45 defined non-response, describing about 40% of treated patients, with roughly 25% six-month survival compared with about 85% below the threshold.

Joint static-dynamic modelling — Louvet

2015 · n = 604

Patients with severe alcohol-related hepatitis treated with corticosteroids from French and UK databases (derivation n = 538), validated in corticosteroid trial cohorts from the United States, France, Korea and Belgium (n = 604). Three joint-effect models were compared: Maddrey+Lille, MELD+Lille and ABIC+Lille.

Every joint model predicted two- and six-month survival significantly better than static or dynamic scores used alone, in both derivation and validation cohorts — establishing that baseline severity and day-7 response carry complementary rather than overlapping information.

STOPAH trial context — Thursz

2015

A multicentre randomised trial of prednisolone and pentoxifylline in severe alcohol-related hepatitis, which framed the modern evidence on how much benefit corticosteroids actually deliver and therefore on the stakes of continuing them in a non-responder.

Prednisolone's mortality benefit at 28 days did not reach statistical significance, and corticosteroid treatment was associated with more serious infections — sharpening the argument for stopping steroids early in patients the Lille model identifies as not responding.

How it compares

Lille Model vs Maddrey's Discriminant Function

Maddrey's DF decides who starts corticosteroids at admission; the Lille model decides who should stop them at day 7 — they are sequential steps in one pathway, not competing scores.

A discriminant function of 32 or above is the conventional entry criterion for corticosteroid treatment, and it was the definition of 'severe' used to assemble the Lille derivation cohort. Lille then evaluates what happened over the following week using the fall in bilirubin. Neither substitutes for the other: without Maddrey's DF there is no indication to treat, and without Lille there is no defined point at which treatment is judged to have failed.

Open the Maddrey's Discriminant Function calculator →Louvet A, Naveau S, Abdelnour M, et al. The Lille model: a new tool for therapeutic strategy in patients with severe alcoholic hepatitis treated with steroids. Hepatology. 2007;45(6):1348-1354.

Lille Model vs ABIC score

ABIC grades baseline risk into three tiers at admission while Lille measures response at day 7, and using them together predicts survival better than either in isolation.

ABIC is a static admission score built from age, bilirubin, INR and creatinine, producing low, intermediate and high-risk groups. Lille is dynamic and requires a week of treatment before it can be computed. Louvet and colleagues formally tested the pairing — ABIC+Lille alongside Maddrey+Lille and MELD+Lille — across 538 derivation and 604 validation patients, and every joint model beat static or dynamic scoring alone for two- and six-month survival.

Open the ABIC score calculator →Louvet A, Labreuche J, Artru F, et al. Combining data from liver disease scoring systems better predicts outcomes of patients with alcoholic hepatitis. Gastroenterology. 2015;149(2):398-406.

Lille Model vs Glasgow Alcoholic Hepatitis Score

GAHS predicts at admission who is likely to benefit from corticosteroids; Lille confirms at day 7 whether that prediction held for the individual patient in front of you.

GAHS separates patients above and below a threshold of 9, with steroid survival benefit confined to the higher group — a predictive claim made before treatment starts. Lille makes no prediction at all; it measures. The two are complementary in an obvious way: GAHS informs the decision to treat, Lille audits it a week later, and a GAHS-positive patient who turns out to be a Lille non-responder is exactly the patient in whom stopping steroids early matters most.

Open the Glasgow Alcoholic Hepatitis Score calculator →

Pearls & pitfalls

  • The bilirubin term is the fall from day 0 to day 7, so a decrease enters as a positive number. Reversing the sign inverts the model's most important variable.
  • Prothrombin time is in seconds, not INR. This is the most frequent unit error in Lille calculation and it is not a small one.
  • The formula expects SI units — albumin in g/L, bilirubin in µmol/L — which is the opposite convention from ABIC and Maddrey's DF, both of which use mg/dL.
  • The day-0 bilirubin must be captured when steroids start. There is no way to compute a Lille score retrospectively without it, and it is easily lost if treatment begins before the score is anticipated.
  • Renal insufficiency is binary at a creatinine of 1.3 mg/dL, so it does not scale with the severity of kidney injury.
  • A non-responder score is a reason to stop steroids, not merely to note poor prognosis — continued immunosuppression in that setting adds infection risk without survival benefit.
  • Lille says nothing about untreated patients and is not a severity score; a patient never started on steroids has no meaningful Lille result.

Critical actions

  • Record the day-0 bilirubin, albumin, prothrombin time and creatinine at the moment corticosteroids are started, so the day-7 score can actually be calculated.
  • Calculate the score on day 7 and act on it — stop corticosteroids in non-responders rather than completing a fixed course out of habit.
  • Screen actively for infection before and during steroid treatment, and again when a non-responder result prompts a change of plan.
  • Assess early transplant candidacy in selected non-responders, ideally through a service with an established pathway, rather than treating non-response as the end of options.
  • Pair the Lille result with a baseline score such as ABIC or MELD, since the combination predicts survival better than either alone.
  • Address abstinence, nutrition and thiamine in every patient regardless of response category — none of these appear in the model, and all affect outcome.

Why this score exists

The authors' framing was that early identification of non-responders was 'crucial', and the word choice reflects a specific clinical frustration: corticosteroids were the only therapy with any evidence base in severe alcohol-related hepatitis, which created pressure to persist with them even when a patient was visibly not improving. Their contribution was to make 'not improving' measurable at a point early enough to act on, and to define it as a probability rather than a clinical impression. The explicit secondary purpose was to enable trials of alternative therapies — a salvage-therapy trial is impossible without an agreed, reproducible definition of who has failed first-line treatment. That the term 'non-responder' now has a numeric definition at all is the model's real legacy.

About the creator

  • Alexandre Louvet

    First author, 2007 derivation study

    Derived the Lille model to define corticosteroid non-response at day 7, and later led the work combining it with static scores such as ABIC and MELD.

  • Philippe Mathurin

    Senior author

    Led the Lille group's programme on severe alcohol-related hepatitis, including early liver transplantation for selected non-responders.

Limitations

  • It requires seven days of treatment before it yields anything, so it cannot inform the initial decision to give corticosteroids.
  • It depends on a prospectively recorded day-0 bilirubin, which makes it impossible to apply retrospectively if baseline values were not captured.
  • Renal insufficiency is dichotomised at a single creatinine threshold, discarding information about the severity of kidney injury that heavily influences outcome.
  • The 0.45 threshold was derived in a specific corticosteroid-treated European cohort, and patients close to the cut-off should not be managed as though the boundary were sharp.
  • It was developed before early liver transplantation for alcohol-related hepatitis became an option, so it identifies non-responders without addressing what should follow.
  • It contains no measure of infection, which is both a major cause of death in this population and the principal harm of the treatment being assessed.
  • A shorter assessment interval has been proposed by some groups, and the optimal day on which to judge response is not fully settled.

If you are the patient

The Lille score is used about a week after starting steroid treatment for severe alcohol-related hepatitis, to check whether the treatment is helping. It is worked out from your age, some blood tests taken when treatment started (a protein called albumin, a clotting test, and kidney function), and — most importantly — how much your bilirubin, the blood test that reflects jaundice, has fallen over those seven days. The result is a number between 0 and 1. Below 0.45 suggests the steroids are working and they are usually continued. At 0.45 or above, the steroids are unlikely to be helping, and because they also increase the risk of serious infection, doctors will normally stop them rather than continue. That is not the end of treatment: your team will focus on other support, and for some carefully selected people a liver transplant can be considered. Stopping alcohol completely remains the single most important factor in long-term survival.

Frequently asked questions

When is the Lille score calculated?#

On day 7 of corticosteroid treatment for severe alcohol-related hepatitis. It needs both the day-0 and the day-7 bilirubin, so the baseline value must be recorded when steroids are started.

What Lille score means steroids are not working?#

0.45 or above defines a non-responder. That group had roughly 25% six-month survival in the derivation study, compared with about 85% for those scoring below 0.45, and represented around 40% of treated patients.

What should happen if a patient is a Lille non-responder?#

Corticosteroids should generally be stopped, because continuing them adds infection risk without survival benefit. Early liver transplantation can be considered in carefully selected patients; otherwise management focuses on supportive care, infection control, nutrition, abstinence support and honest prognostic discussion.

Does the Lille model use INR or prothrombin time?#

Prothrombin time in seconds. Substituting INR is a common error and produces a badly wrong score, because the two measures are on completely different scales.

Which units does the Lille formula need?#

SI units — albumin in g/L and bilirubin in µmol/L — which is the opposite convention from ABIC and Maddrey's discriminant function. Multiply albumin g/dL by 10, and bilirubin mg/dL by 17.1.

Can the Lille score be used in patients not on steroids?#

No. It measures response to corticosteroid treatment specifically, and has no meaning as a standalone severity or prognostic score in an untreated patient.

Should Lille be used alongside a baseline score?#

Yes. Joint models pairing Lille with Maddrey's DF, MELD or ABIC predicted two- and six-month survival significantly better than either static or dynamic scoring alone, across 538 derivation and 604 validation patients.

Related calculators

  • Maddrey's DF — Alcoholic hepatitis severity
  • GAHS — Glasgow alcoholic hepatitis score
  • ABIC Score — Age, bilirubin, INR, creatinine — alcoholic hepatitis
  • MELD-Na — Assesses the severity of chronic liver disease
  • Alcohol Content — Standard drinks & alcohol grams calculator

References

Original / primary reference

  1. Louvet A, Naveau S, Abdelnour M, et al. The Lille model: a new tool for therapeutic strategy in patients with severe alcoholic hepatitis treated with steroids. Hepatology. 2007;45(6):1348-1354.

Validation and combined modelling

  1. Louvet A, Labreuche J, Artru F, et al. Combining data from liver disease scoring systems better predicts outcomes of patients with alcoholic hepatitis. Gastroenterology. 2015;149(2):398-406.
  2. Thursz MR, Richardson P, Allison M, et al. Prednisolone or pentoxifylline for alcoholic hepatitis. N Engl J Med. 2015;372(17):1619-1628.

Last updated July 30, 2026. Clinical knowledge base written and curated by GastroAGI Team from primary medical literature.

Written from primary literature and not yet independently clinically reviewed.

For use by qualified healthcare professionals. This calculator supports clinical judgement and does not replace it.