Lille Score Calculator

The Lille model calculates a prognostic score between 0 and 1, which represents the predicted probability of mortality at six months. The core calculation relies on a logistic regression equation that integrates several weighted variables: patient age, initial albumin levels, day-0 bilirubin, day-7 bilirubin, serum creatinine, and prothrombin time (or INR). First, an intermediate variable r is determined using the formula: r = 3.19 - (0.101 * age) + (0.147 * albumin) + (0.0165 * (bilirubin_level - bilirubin_day)) - (0.206 * if_creatinine_over_1.3) - (0.0065 * bilirubin_day) - (0.0096 * prothrombin). Next, the final Lille score is derived via the exponential logistic function: Score = exp(-r) / (1 + exp(-r)). A score above 0.45 generally indicates a poor response to corticosteroids, signaling that alternative interventions like liver transplantation evaluation should be considered.

Consider a 50-year-old male patient undergoing corticosteroid treatment for severe alcoholic hepatitis. His clinical parameters on day 7 are recorded as follows: Age is 50 years, baseline albumin is 30 g/L, day-0 bilirubin is 200 umol/L, day-7 bilirubin drops to 120 umol/L, serum creatinine is 1.1 mg/dL (not exceeding 1.3), and prothrombin time is 60 percent. First, compute the change in bilirubin: 120 - 200 = -80. Next, calculate the intermediate variable r: r = 3.19 - (0.101 * 50) + (0.147 * 30) + (0.0165 * -80) - (0.206 * 0) - (0.0065 * 200) - (0.0096 * 60). This evaluates to r = 3.19 - 5.05 + 4.41 - 1.32 - 0 - 1.30 - 0.58 = -0.65. Finally, apply the exponential transformation: Score = exp(0.65) / (1 + exp(0.65)) = 1.916 / (1 + 1.916) = 0.657. Because the resulting score is 0.657 (which exceeds the 0.45 threshold), it indicates a non-response to steroids.

Ensure that day-7 bilirubin measurements are captured precisely on the seventh day of corticosteroid administration to avoid misinterpretation of the trajectory. Always cross-verify lab units, as discrepancies between milligrams per deciliter and micromoles per liter will severely distort the output. Remember that the Lille score is exclusively validated for patients receiving corticosteroid treatment for severe alcoholic hepatitis and should not be used as a general prognostic tool for other liver pathologies.