Clinical Overview
The Lille Model is a critical decision-making tool in hepatology. Patients with severe alcoholic hepatitis (often identified by a Maddrey DF ≥ 32) are started on corticosteroids. However, steroids carry immense risks (infection, GI bleeding). The Lille score is calculated at day 7 to determine if the steroids are actually working.
Pathophysiology & Evidence
Alcoholic hepatitis drives massive systemic inflammation and jaundice. If corticosteroids are effectively halting the immune-mediated destruction of hepatocytes, the patient's serum bilirubin should drop significantly by day 7. The Lille model heavily weights this dynamic change in bilirubin.
Formula Breakdown
Score = f(Age, Albumin, Day 0 Bilirubin, Day 7 Bilirubin, Creatinine, PT)
If the calculated score is ≥ 0.45, the patient is deemed a "non-responder." Continuing steroids in these patients increases the risk of fatal sepsis without improving liver recovery, so steroids are immediately halted.