Abstract: Objective To assess the value of PASP and RVAW combined Scr in the prognosis of COPD-PH. Methods The COPD-PH patients admitted to People's Hospital of Ningxia Hui Autonomous Region from January to June 2021 were retrospectively analyzed and followed up 1 year after discharge, and were divided into death and survival groups according to survival status. We compared the clinical data such as general condition, laboratory indices, and echocardiographic parameters between the two groups. With death occurred in COPD-PH as the dependent variable and body mass index, pulmonary artery systolic pressure, right ventricular anterior wall thickness, right ventricular anteroposterior diameter, RDW-SD, albumin, creatinine, urea nitrogen, as well as fibrinogen degradation products as the independent variables, Logistic regression analysis was used to analyze the risk factors for COPD-PH death. ROC curves were used to assess the effectiveness of each risk factor alone and in combination to predict COPD-PH death. Results A total of 85 patients were included in this study, 26 (30.59%) in the death group and 59 (69.41%) in the survival group. Compared with the surviving,pulmonary artery systolic pressure (PASP) [65.00 mm Hg(48.25 mm Hg, 85.25 mm Hg) versus 40.20 mm Hg(36.95 mm Hg, 53.33 mm Hg)], right ventricular anterior wall thickness (RVAW) [4.10 mm(3.80 mm, 6.70 mm) versus 3.80 mm(3.60 mm, 4.00 mm)], serum creatinine (Scr) [76.50 μmmol/L(65.25 μmmol/L, 93.25 μmmol/L) versus 66.00 μmmol/L(56.00 μmmol/L, 72.00 μmmol/L)] were higher in the death group, and the differences were statistically significant. Logistic regression analysis showed an increase in pulmonary artery systolic pressure(OR=1.055, 95% CI 1.011~1.100, P=0.013), right ventricular anterior wall thickening (OR=2.321, 95%CI 1.138~4.732, P=0.021), and increased creatinine (OR=1.051, 95%CI 1.017~1.086, P=0.003) were independent risk factors for death of patients with COPD-PH. ROC curve analysis suggested that the combination of PASP+RVAW+Scr predicted the best value of COPD-PH death( AUC=0.858, sensitivity =80.0%, and specificity= 81.0%), which were enhanced compared to their respective individual predictions. Conclusion PASP and RVAW combined with Scr have clinical value in identifying COPD-PH patients at risk of death.

Key words: COPD-PH, prognosis, PASP, RVAW, serum creatinine