Lille Score Calculator

The Lille Score Calculator is a useful tool for assessing the prognosis of patients with severe alcoholic hepatitis undergoing corticosteroid therapy. It helps clinicians make treatment decisions based on patient response.

Historical Background

The Lille score was developed in 2006 as a predictive model for patients with severe alcoholic hepatitis undergoing corticosteroid treatment. Severe alcoholic hepatitis has a high mortality rate, and corticosteroid therapy can be life-saving for some patients. The Lille model helps in assessing whether continuing corticosteroid treatment is likely to benefit the patient.

Calculation Formula

The Lille Score calculation is based on several clinical variables. The formula is as follows:

\[ \text{Lille Score} = \frac{1}{1 + e^{-L}} \]

Where \( L \) is computed as:

\[ L = 3.19 + (0.101 \times \text{Age}) + (0.147 \times \Delta \text{Bilirubin}) + (0.0165 \times \text{Creatinine}) - (0.206 \times \text{Albumin}) - (0.0065 \times \text{Prothrombin Time}) \]

\(\Delta \text{Bilirubin}\) is the relative change in bilirubin levels from day 0 to day 7:

\[ \Delta \text{Bilirubin} = \frac{\text{Bilirubin Day 7} - \text{Bilirubin Day 0}}{\text{Bilirubin Day 0}} \]

Example Calculation

For a patient with:

• Age: 50 years
• Bilirubin on Day 0: 200 μmol/L
• Bilirubin on Day 7: 150 μmol/L
• Creatinine: 100 μmol/L
• Albumin: 30 g/L
• Prothrombin Time: 15 seconds

First, calculate \(\Delta \text{Bilirubin}\):

\[ \Delta \text{Bilirubin} = \frac{150 - 200}{200} = -0.25 \]

Then calculate \( L \):

\[ L = 3.19 + (0.101 \times 50) + (0.147 \times -0.25) + (0.0165 \times 100) - (0.206 \times 30) - (0.0065 \times 15) = 4.9775 \]

Finally, the Lille Score:

\[ \text{Lille Score} = \frac{1}{1 + e^{-4.9775}} = 0.9932 \]

Importance and Usage Scenarios

The Lille Score is important in guiding clinical decisions regarding the continuation of corticosteroid therapy for patients with severe alcoholic hepatitis. A score greater than 0.45 indicates a poor response to corticosteroid treatment, and stopping therapy might be recommended. It helps in optimizing the management strategy, thus potentially reducing unnecessary side effects from ineffective treatments.

Common FAQs

1. What is the Lille Score used for?

   • The Lille Score is used to determine the prognosis of patients with severe alcoholic hepatitis receiving corticosteroid therapy. It helps in assessing whether the treatment should continue.

2. 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 therapy, and it may be advisable to discontinue treatment.

3. How is \(\Delta \text{Bilirubin}\) calculated?

   • \(\Delta \text{Bilirubin}\) is calculated as the change in bilirubin levels between day 7 and day 0, divided by the bilirubin level on day 0.

4. Is the Lille Score applicable to all liver diseases?

   • No, the Lille Score is specifically developed for assessing patients with severe alcoholic hepatitis undergoing corticosteroid therapy.

The Lille Score Calculator is a critical tool in helping healthcare professionals make informed decisions about the course of treatment for patients with severe alcoholic hepatitis, aiming to improve survival outcomes and manage the disease effectively.