Abstract: Objective To retrospectively analyze the distribution of dead inpatients with chronic obstructive pulmonary disease(COPD),causes of their death,and relative risk factors for death. Methods A total of 4 960 COPD patients admitted to Chinese PLA General Hospital,Beijing Union Medical College Hospital and Beijing Hospital from January 2000 to March 2010,covered in medical record database,were retrospectively analyzed in this study.Of these patients,361(221 males and 140 females) were dead cases(7.28%),their mean age was(67.6±11.70) years and(72.2±10.40) years,their mean hospital stay time was(25.39±7.58)d and(27±7.9)d of males and(20±6.7)d of females. Results Age,COPD,respiratory failure,chronic renal function failure,diabetes and elevated blood sugar level were positively correlated with the death of COPD inpatients.The most important risk factor for death of COPD patients was respiratory failure(19.94%),followed by chronic renal function failure(14.40%),acute renal function failure(12.74%),pulmonary heart disease(11.36%),cardiac failure(10.80%),acute myocardial infarction(9.42%),malignant tumor(5.54%),ventricular flutter/ventricular fibrillation/ventricular tachycardia(5.26%),cerebral infarction(4.98%),pulmonary embolism(3.05%),and cerebral hemorrhage(2.49%). Conclusion Diseases of respiratory system and other systems are the main cause of death of COPD patients,thus systemic treatment and protection of organs play an important role in the prognosis of COPD patients.