Acute Alcoholic Hepatitis Mortality Lille Score Calculator

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What Is the Lille Score Calculator?

The Lille Score Calculator is a medical decision-support tool designed to help healthcare professionals evaluate the short-term prognosis of patients suffering from severe alcoholic hepatitis. This form of hepatitis is a serious liver condition caused by heavy and prolonged alcohol consumption, and it can lead to significant liver damage, liver failure, and even death.

When a patient is diagnosed with severe alcoholic hepatitis, one common treatment involves corticosteroids to reduce liver inflammation. However, not all patients respond to this therapy. The Lille score helps determine whether a patient is benefiting from corticosteroid treatment by evaluating changes in key blood test results between the start of treatment (day 0) and after 7 days.

The score is calculated using a specific formula that includes several clinical inputs:

  • Age of the patient
  • Bilirubin levels at day 0 and day 7 (a measure of liver function)
  • Creatinine at day 0 (a measure of kidney function)
  • Albumin at day 0 (a liver protein indicating nutritional and liver status)
  • PT/INR at day 0 (a test showing how well the blood clots)

The result, called the "Lille score," is a number between 0 and 1. A lower Lille score (usually below 0.45) suggests that the patient is responding well to treatment, while a higher score (above 0.45) indicates a poor response, which may prompt doctors to consider stopping corticosteroid therapy and exploring alternative options.

This calculator is an aid to support clinical decisions, not a replacement for a medical evaluation. It should be used by or in consultation with qualified healthcare providers, as interpreting the result properly requires a full understanding of the patient’s condition and medical history.

The Lille Score Calculator plays an important role in improving patient care by helping to avoid ineffective treatments and focusing on the best path forward for those battling severe alcoholic hepatitis.

Who Should Use This Calculator?

The Lille Score Calculator is intended primarily for use by healthcare professionals, including doctors, hepatologists, and clinical staff involved in the care of patients with severe alcoholic hepatitis. It is a valuable tool in hospital settings where corticosteroid treatment has been initiated and a decision needs to be made after 7 days about whether to continue or stop therapy.

While the calculator is accessible online and easy to use, it requires specific lab values and clinical data that are typically only available through medical testing and evaluation. For this reason, it is not designed for use by patients or the general public on their own. Interpreting the Lille score correctly also requires an understanding of the patient's overall health, liver function, and treatment goals.

If you are a patient or a caregiver seeking information about alcoholic hepatitis or treatment progress, it’s important to consult a doctor. The Lille score is just one part of a broader clinical assessment, and treatment decisions should always be guided by professional medical advice.

In summary, this calculator is a tool for:

  • Doctors managing patients with severe alcoholic hepatitis
  • Clinical staff monitoring treatment response
  • Medical researchers evaluating liver disease outcomes

Understanding the Inputs

To calculate the Lille score accurately, several clinical values are required. These inputs are typically gathered through blood tests and clinical evaluations done in a hospital setting. Here’s a breakdown of each input used in the calculator:

Age

The patient’s age is an important factor because older patients generally have a higher risk of complications and may respond differently to treatment. Age is entered in full years at the time treatment begins.

Bilirubin (Day 0 and Day 7)

Bilirubin is a substance produced by the liver, and its levels in the blood indicate how well the liver is functioning. In the Lille score, bilirubin is measured twice:

  • Day 0: Before corticosteroid treatment starts
  • Day 7: After 7 days of treatment

A significant drop in bilirubin levels by day 7 suggests that the liver is responding well to therapy. Persistently high levels may indicate poor treatment response.

Creatinine

Creatinine is a waste product filtered by the kidneys. High levels in the blood may point to kidney dysfunction, which is common in patients with advanced liver disease. The calculator uses the value from day 0 (before treatment), and it can be entered in different units (µmol/L, mg/L, or mg/dL).

Albumin

Albumin is a protein made by the liver. Low albumin levels often reflect poor liver function or nutritional status. This input is measured at day 0 and is included in the score to provide a broader picture of the patient’s overall condition.

PT / INR (Prothrombin Time / International Normalized Ratio)

This test measures how long it takes blood to clot and is another way to assess liver function. The liver produces proteins needed for clotting, so impaired liver function can lead to prolonged clotting times. The calculator uses this value from day 0.

All these values work together in the Lille formula to estimate how well a patient is responding to treatment for alcoholic hepatitis. They provide a snapshot of liver and kidney function, age-related risk, and response to therapy, helping doctors make informed decisions about continuing or changing treatment plans.

Step-by-Step: How to Use the Calculator

Using the Lille Score Calculator is simple if you have the required lab values. Follow these steps to calculate your score:

  1. Enter the patient's age in full years.
  2. Input the bilirubin level on day 0 (before starting corticosteroid treatment).
  3. Input the bilirubin level on day 7 (after 7 days of treatment).
  4. Enter the creatinine level on day 0. Choose the correct unit from the dropdown menu (µmol/L, mg/L, or mg/dL).
  5. Input the albumin level on day 0 in g/L.
  6. Enter the PT or INR value on day 0. Either PT in seconds or INR value can be used, depending on what is available.
  7. Click the "Calculate" button to generate the Lille score.

The result will appear in the "Result" field. This value ranges from 0 to 1 and helps guide treatment decisions.

Interpreting Your Result

The Lille score result gives insight into how well a patient with severe alcoholic hepatitis is responding to corticosteroid therapy. Here's how to understand the result:

  • Lille Score ≤ 0.45: This suggests that the patient is responding well to corticosteroid treatment. Continuing the therapy may be beneficial.
  • Lille Score > 0.45: This indicates a poor response to treatment. In such cases, continuing corticosteroids may not be effective, and doctors might consider stopping treatment and exploring other care options.

It's important to remember that the Lille score is one piece of the overall clinical picture. Treatment decisions should not be based on the score alone. Other factors such as infection, nutritional status, and overall organ function also play a key role.

Limitations and Warnings

While the Lille Score Calculator is a helpful tool for assessing treatment response in severe alcoholic hepatitis, it has several important limitations and warnings that users should be aware of:

⚠️ Not a Diagnostic Tool

The calculator does not diagnose alcoholic hepatitis or any other condition. It is used only after a confirmed diagnosis and once treatment has already begun. It should never be used as a substitute for medical evaluation or diagnosis.

⚠️ For Professional Use Only

This tool is designed for use by trained healthcare providers. Accurate results depend on proper input of clinical data, correct unit selection, and interpretation within a full medical context. Patients should not attempt to use or interpret this calculator on their own.

⚠️ Dependent on Accurate Lab Results

The accuracy of the Lille score depends entirely on the precision of lab results. Inaccurate or outdated blood test values may lead to misleading outcomes. Always ensure the values used are from reliable, recent tests.

⚠️ Score Alone Is Not Enough

A high or low Lille score should never be the sole reason for continuing or stopping treatment. Other clinical signs, patient progress, and possible complications must all be considered by the treating physician.

⚠️ May Not Apply to All Patients

The Lille score is specifically developed for patients with severe alcoholic hepatitis receiving corticosteroids. It may not be valid or useful for patients with other types of liver disease, or those not on steroid therapy.

⚠️ Medical Supervision Is Essential

Use of this calculator without medical supervision can lead to serious consequences. It is a clinical decision-support tool—not a replacement for proper healthcare and expert advice.

Always consult with a healthcare provider before making any treatment decisions based on this score. It is intended to support informed, thoughtful clinical judgment—not replace it.

FAQs

What is the purpose of the Lille Score?

The Lille Score helps doctors evaluate how well a patient with severe alcoholic hepatitis is responding to corticosteroid treatment. It guides decisions about whether to continue or stop the therapy based on changes in key lab values after seven days.

Can I use this calculator at home as a patient?

No. This calculator is intended for use by healthcare professionals. It requires accurate lab results and clinical interpretation. Patients should never attempt to diagnose or treat themselves based on this score.

What does a high Lille Score mean?

A high Lille Score (greater than 0.45) suggests that the patient is not responding well to corticosteroid treatment and may need a different care approach. Doctors use this information to evaluate the next best steps.

What does a low Lille Score mean?

A low Lille Score (0.45 or below) usually indicates a positive response to corticosteroid treatment, meaning the liver is showing signs of recovery and therapy may be continued.

What if I enter the wrong units for creatinine?

The calculator allows you to select the correct unit for creatinine (µmol/L, mg/L, or mg/dL). Be sure to match the unit to the lab report exactly. Choosing the wrong unit can result in an incorrect Lille score.

Do I need both bilirubin values (day 0 and day 7)?

Yes. The Lille Score calculation depends on the change in bilirubin levels from the start of treatment (day 0) to one week later (day 7). Without both values, the score cannot be calculated accurately.

Does the Lille Score apply to all liver diseases?

No. The Lille Score is specifically designed for patients with severe alcoholic hepatitis who are undergoing corticosteroid treatment. It is not intended for other liver conditions or treatment types.

Is the result 100% accurate?

The Lille Score is a widely accepted and validated clinical tool, but it should never be used in isolation. Results should always be interpreted by a healthcare professional alongside other clinical findings and the patient's overall condition.

Disclaimer

The Lille Score Calculator is provided for educational and informational purposes only. It is designed to assist qualified healthcare professionals in evaluating the response to corticosteroid treatment in patients with severe alcoholic hepatitis. The tool is not intended for use by the general public and should not be used to make medical decisions without proper medical training.

This calculator does not provide medical advice, diagnosis, or treatment. The results generated by the calculator are based on the values entered and should be interpreted in the context of a complete clinical evaluation. Incorrect data entry or misunderstanding of the score may lead to inaccurate conclusions.

Always consult a licensed healthcare provider before making any changes to a treatment plan. Use of this tool does not establish a doctor-patient relationship, and the creators of this calculator are not responsible for any decisions or outcomes resulting from its use.

By using this calculator, you agree that it is used at your own risk and that it is not a substitute for professional medical judgment, diagnosis, or treatment.

References

  • Louvet A, Labreuche J, Artru F, 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.
  • Mathurin P, O’Grady J, Carithers RL, et al. Corticosteroids improve short-term survival in patients with severe alcoholic hepatitis: Meta-analysis of individual patient data. Gut. 2011;60(2):255-260.
  • Singal AK, Bataller R, Ahn J, et al. ACG Clinical Guideline: Alcohol-associated liver disease. Am J Gastroenterol. 2020;115(2):177-194.