Silvia Salvatori, Chiara Venuto, Diana Giannarelli, Elena De Cristofaro, Rocco Spagnuolo, Federico Carrabetta, Paola Balestrieri, Francesca Baldaro, Irene Mignini, Gabriele Rumi, Diletta Immacolata Lavigna, Valentin Calvez, F. Scaldaferri, F Luzza, Michele Cicala, D Della-Morte, Emma Calabrese, Giovanni Monteleone, Irene Marafini
BACKGROUND: Frailty is a multidimensional syndrome associated with poor outcomes and increased vulnerability, yet its assessment in inflammatory bowel diseases (IBD) remains challenging due to the absence of disease-specific tools. AIMS: This study aimed to develop and validate the IBD Frailty Score, a tailored instrument for evaluating frailty in patients with Crohn disease (CD) and ulcerative colitis (UC). METHODS: In the development phase, 28 categorical items were included in the IBD Frailty Score. This tool was tested in an exploratory cohort of 121 IBD outpatients and later validated in a prospective multicenter cohort of 512 patients across four tertiary centers. Predictive factors of frailty were identified through univariate and multivariate analyses. RESULTS: The IBD Frailty Score was feasible, with an average administration time of ∼2 minutes. It correlated positively with the Fried Frailty Phenotype, IBD Disability Index, and Charlson Comorbidity Index and showed good reproducibility (rho = 0.78) and strong diagnostic accuracy (AUC = 0.79). A cut-off score of 4 reliably distinguished fit from frail patients. Increasing age, polypharmacy, history of extraintestinal manifestations, and higher disease activity were independent risk factors for frailty. CONCLUSIONS: The IBD Frailty Score is the first validated, disease-specific tool for assessing frailty in IBD. It is practical, reproducible, and correlates well with established measures.