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However, its impact on AECOPD+SCAP patients remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>To assess hypercapnia\u2019s effects on inflammatory responses and short-term outcomes in AECOPD+SCAP patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>This retrospective, dual-center study included 185 hospitalized AECOPD+SCAP patients from January 2014 to June 2025.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      Patients were stratified by PaCO\n                      <jats:sub>2<\/jats:sub>\n                      levels on the day of admission: hypercapnia (&gt;45\u2009mmHg), normocapnia (35\u201345\u2009mmHg), and hypocapnia (&lt;35\u2009mmHg). Data were collected on clinical data, biomarkers (procalcitonin [PCT], C-reactive protein [CRP], lactate and red cell distribution width coefficient of variation [RDW-CV]) and 30-day survival.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The three groups had similar invasive mechanical ventilation needs and in-hospital and 30-day mortality. Hypercapnic patients (especially with acidosis) had a higher intensive care unit (ICU) admission risk than normocapnic patients. The hypercapnia group had lower PCT, CRP and lactate levels versus the hypocapnia group (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.05), while RDW-CV showed no significant intergroup differences(\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&gt;\u20090.05). Such trends persisted in ICU-admitted patients, largely independent of acidosis and were unaffected by prior systemic corticosteroid therapy. Multivariate analysis indicated hypercapnia, PaO\n                      <jats:sub>2<\/jats:sub>\n                      \/FiO\n                      <jats:sub>2<\/jats:sub>\n                      , lactate, and RDW-CV could independently predict ICU admission. The nomogram incorporating these predictors showed good discriminatory ability (area under the curve\u2004=\u20040.72), comparable to pneumonia severity scores (CURB-65, PSI, SMART-COP, and Quick SOFA), with clinical utility confirmed by calibration and decision curve analyses.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>\n                      Hypercapnia in AECOPD+SCAP patients could indicate higher ICU admission risk (especially in cases of acidosis) and impaired early anti-inflammatory responses, which are largely independent of acidosis. The combination of hypercapnia, RDW-CV, PaO\n                      <jats:sub>2<\/jats:sub>\n                      \/FiO\n                      <jats:sub>2<\/jats:sub>\n                      ratio, and lactate levels can help to identify patients requiring intensive care.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17534666261467258","type":"journal-article","created":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T12:20:16Z","timestamp":1783686016000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Hypercapnia is associated with an increased risk of ICU admission and reduced inflammatory responses in AECOPD patients with severe pneumonia"],"prefix":"10.1177","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6165-1745","authenticated-orcid":false,"given":"Shan","family":"Mou","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases, The First People\u2019s Hospital of Shuangliu District, Chengdu, Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi","family":"Cai","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, The First People\u2019s Hospital of Shuangliu District, Chengdu, Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Hospital Administrative Office, The First People\u2019s Hospital of Shuangliu District, Chengdu, Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaohao","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Institute for Viral Hepatitis, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Mao","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The First People\u2019s Hospital of Shuangliu District, Chengdu, Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lijuan","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Unit, The First People\u2019s Hospital of Shuangliu District, Chengdu, Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, Chengdu Shuangliu District Hospital of Traditional Chinese Medicine, Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-8713-2992","authenticated-orcid":false,"given":"Yan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Institute for Viral Hepatitis, The Second Affiliated Hospital, Chongqing Medical University, Chongqing 400010, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,10]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1165\/rcmb.2012-0487OC"},{"issue":"5","key":"e_1_3_5_3_2","first-page":"564","article-title":"Effect of hypercapnia on the clinical prognosis and severity of infection in patients with severe communityacquired pneumonia","volume":"32","author":"Liu XQ","year":"2020","unstructured":"Liu XQ, Wen MY, Ding HG, et al. 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