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end stage CHF - life expectancy?
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end stage CHF - life expectancy?

I wonder if you could give me your judgement about how long my dad has to live. He is in the hospital - admitted with kidney failure from CHF. He had been retaining fluid in his ankles and his abdomen.  He was treated with dopamine and Primacor and the fluid did release - he lost 20 pounds (fluid?) in a few days.  He has lost a total of 30 pounds over the last year.  He has constant shortness of breath and little energy.  His heart monitor shows constant arrythmia and PVCs and the alarms are always going off. His blood pressure has decreased - it currently averages about 90/40. He is 85 and we are told his heart is very enlarged.  Your answer may help us make decisions regarding his care. Thank you very much.
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Dear Patco,

I can't tell you how long your dad has to live (no one can) but I can give you an idea about prognostic factors.  For individuals with class 4 heart failure (fatigue at rest) after 5 years more than half will die.  If the individual has kidney failure the mortality doubles over that period.   Low blood pressure not due to medications carries an increased risk as well.  Hope these numbers help.  His doctors can probably give you a better time frame (e.g weeks, months or years) to help in decision making as well.  These are difficult decisions and I would encourage you to also discuss things with your dad.  The most important thing is to try to follow what his choices for end-of-life care may be.
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