A major development is that a new study utilising machine learning algorithms found that people with IBD who develop chronic diseases earlier in life have a considerably increased chance of premature death, defined as death before the age of 75. 

Researchers examined health care data from Ontario stored at ICES (previously the Institute for Clinical Evaluative Sciences) to see if machine learning methods, which are already used to predict premature death in the general population, could accurately predict early mortality in IBD patients. 

According to available data, Canada has one of the world's highest rates of inflammatory bowel disease (IBD), with Crohn's disease and ulcerative colitis being the most frequent kinds. 

"The clinical implication is that chronic conditions developed early in life may be more important in determining a patient's health trajectory, although further causal research is needed to elucidate this relationship," writes Dr Eric Benchimol, a paediatric gastroenterologist and senior scientist at The Hospital for Sick Children (SickKids) and professor of paediatrics and epidemiology at the Temerty Faculty of Medicine, University of Toronto. He continues: "Although our insights are not causal insights, they identify patients potentially at higher risk of premature death and therefore who might benefit from more coordinated care of their IBD and other chronic conditions." 

Between 2010 and 2020, 9278 persons with IBD died, with over half of them (47%) classed as premature deaths. Surprisingly, the rate of early death was higher in men (50%) than in women (44%). 

Chronic illnesses play an important influence in determining the life expectancy of people with inflammatory bowel disease (IBD), increasing the risk of early mortality. Among these, arthritis emerged as the most common condition, accounting for 77% of IBD patients who died prematurely. Chronic inflammation caused by arthritis, along with immunological dysregulation observed in IBD, might worsen overall health. Similarly, hypertension was found in 73% of patients, increasing the strain on cardiovascular health and the risk of catastrophic consequences, including heart attacks and strokes. 

Mood problems, such as anxiety and depression, affected 69% of these patients. The psychological burden of managing a lifelong diagnosis such as IBD, combined with the chronic pain and exhaustion associated with arthritis and hypertension, is likely to contribute to poor mental health outcomes. Untreated mental problems can cause poor adherence to treatment measures, exacerbating illness progression and raising the risk of premature death. 

Kidney failure, which accounts for 50% of premature deaths, represents the systemic effects of chronic inflammation, in which persistent immune activation affects essential organs. The additional load of impaired kidney function reduces the body's resilience, rendering patients more susceptible to serious consequences. Lastly, the fact that cancer was found in 46% of cases shows the long-term risk that comes with IBD's chronic inflammation and immune system dysregulation, which can lead to cancer, especially colon cancer. 

The interaction of various chronic illnesses creates a complicated clinical picture in which numerous systems are impacted simultaneously, hastening the trend to premature death. Early detection and tailored care of these comorbidities are critical for improving outcomes and increasing the longevity of IBD patients. 

The study found that integrating chronic illnesses detected before the age of 60, as well as the age of diagnosis, greatly enhanced the model's ability to predict early mortality in these patients. 

Researchers were able to improve their forecasts by using machine learning technologies on health-care data. "The use of premature death as the outcome more directly identifies opportunities for health system improvements, as premature deaths are considered avoidable through appropriate prevention or early and effective treatment," the paper's authors wrote. 

Gemma Postill, a medical student at the Temerty Faculty of Medicine, co-led the study with Dr Laura Rosella, a professor and Canada Research Chair in Population Health Analytics at the Dalla Lana School of Public Health. Their findings highlight the value of using advanced predictive algorithms to guide clinical actions. 

The authors propose a comprehensive, multidisciplinary approach to managing IBD and related chronic diseases. They recommend integrating a variety of healthcare practitioners, including nutritionists and mental health specialists, to reduce the risk of premature mortality. 

"These findings provide scientific support for providing multidisciplinary and integrated health care across the lifespan (particularly during young and middle adulthood)," the study's authors write. 

The study highlights the crucial need for a paradigm shift in how IBD patients with multiple chronic diseases are treated. Early identification of high-risk individuals, followed by personalised and coordinated care, has the potential to reduce premature mortality. Canada grapples with one of the world's highest IBD rates; utilising AI in healthcare has the potential to significantly reduce needless mortality.