Lille Score Helps Cut Death Risk in Severe Alcohol Hepatitis

A new look at how doctors treat severe alcohol‑related hepatitis shows a simple scoring system can change outcomes. The Lille score predicts who will respond best to steroid therapy.

Researchers searched for all random trials from 2007 to 2025 that gave steroids to patients with a MELD score over 20. They gathered 13 studies, 14 treatment groups, and 1,294 patients. Four of those groups used the Lille score to decide the dose. The rest gave steroids without that guidance.

When they compared deaths at 28 days, the Lille‑guided groups had about 8% death rate, while the others were around 21%. At 90 days, the gap widened: 15% versus 40%. By 180 days the numbers were close: 35% versus 48%. Infection rates stayed the same across both approaches.

These results suggest the Lille score really helps lower death risk in severe alcohol hepatitis. Doctors can use it to pick the right patients for steroids. More research is still needed, but the data support its use.