Objective To explore the cause,treatment and the death-related factors of respiratory failure complicated by pulmonary infections in the elderly patients with COPD.Methods The clinical data of 126 elderly COPD inpatients with respiratory failure complicated by lung infections were retrospectively analyzed,and compared with the data of 110 old non-COPD patients.Results The related causes for these two complications in COPD were:age,primary disease and complications,infection of lungs and pathogens,improper treatment and rescue.The death-related causes for these patients were:pathogens,respiratory failure and infection of the lungs.Infection of the lungs was considered to be the most important and most dangerous cause.Conclusion Infection of lungs is the most dangerous death cause for the respiratory failure,rational use of antibiotic is the key point to improve the respiratory failure and reduce the death rate.