Abstract:Objective To observe the changes of serum interleukin (IL)-37 levels in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and its predictive role on prognosis. Methods A total of 100 patients with AECOPD caused by pulmonary infection admitted to Qingdao Municipal Hospital from January 2020 to January 2023 were retrospectively selected as the research objects, and were divided into the death group and the survival group according to the prognosis during the hospitalization period. The serum IL-37 levels in the two groups of patients at admission were detected, and its relationship with the death of patients during hospitalization was analyzed, as well as its predictive value for the prognosis of patients. Results Among 100 patients with AECOPD, 12 died and 88 survived. Logistic regression analysis showed that age ≥60 years and high levels of fibrinogen (FIB), D-dimer, and IL-37 were risk factors affecting the prognosis of patients with AECOPD ( P ＜0.05). The results of the receiver operating characteristic (ROC) curve showed that the area under the curve for serum IL-37 to predict prognosis in patients with AECOPD was 0.838, with a sensitivity of 83.3% and a specificity of 80.7%. The restricted cubic spline analysis showed that there was a nonlinear dose-response relationship between serum IL-37 levels and the mortality of AECOPD patients during hospitalization ( r =0.715,P ＜0.01). The decision curve analyses showed that when the high-risk threshold was 0-0.8, the net return was＞0, which was clinically significant, and the smaller the high-risk threshold, the greater the net return. Conclusion Serum IL-37 is strongly associated with the prognosis of patients with AECOPD, and the strength of the association shows a non-linear dose-response relationship, and the detection of serum IL-37 levels can help to predict the risk of death during hospitalization in patients with AECOPD.