Lille model
Response to corticosteroids on day 7 in severe alcohol-associated hepatitis
Sources last checked: 2026-10-13
Lille model
Response to corticosteroids on day 7 in severe alcohol-associated hepatitis
Only meaningful after 7 days of corticosteroids. Prothrombin time in seconds, not INR.
Interpretation
| < 0.45 — responder | About 85 % 6-month survival in the derivation study; Louvet 2007 describes continuing corticosteroids in responders. |
|---|---|
| ≥ 0.45 — non-responder | About 25 % 6-month survival; Louvet 2007 describes stopping corticosteroids in non-responders. |
What is the Lille model?
The Lille model predicts 6-month survival in severe alcohol-associated hepatitis after 7 days of corticosteroids, using the early change in bilirubin with age, albumin, renal function and prothrombin time. Louvet and colleagues in Lille, France, developed it in 2007; a score of 0.45 or more identifies non-responders.
When to use it
- Day 7 of corticosteroid treatment for severe alcohol-associated hepatitis
- Deciding whether to stop corticosteroids
- Stratifying patients for trials of alternative treatments
When not to use it
- Before corticosteroids have been given for 7 days
- Hepatitis of other causes
How it is calculated
R = 3.19 − 0.101 × age + 0.147 × albumin (g/L) + 0.0165 × (bilirubin d0 − d7, µmol/L) − 0.206 × renal insufficiency − 0.0065 × bilirubin d0 − 0.0096 × PT (s); Lille = e^−R / (1 + e^−R).
Clinical pearls and limitations
- Only meaningful after 7 days of corticosteroids. Prothrombin time in seconds, not INR.
- Lille ≥ 0.45: about 25 % 6-month survival versus about 85 % below 0.45 in the original study.
- The bilirubin fall between day 0 and day 7 carries most of the information.
- All lab inputs are in SI units (µmol/L, g/L) as in the source; PT in seconds.
Frequently asked questions
What Lille score means non-response?
A score of 0.45 or higher indicates non-response to corticosteroids.
When is the Lille model calculated?
On day 7 of corticosteroid therapy (some studies have used day 4).
What counts as renal insufficiency in the Lille model?
Serum creatinine above 1.3 mg/dL (115 µmol/L).
Evidence and guidelines
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