Abstract: OBJECTIVE To explore the values of systemic immune-inflammation index (SII) and systemic inflammation response index (SIRI) combined with multiple inflammatory factors in assessment of prognosis of the acute exacerbation of chronic obstructive pulmonary disease (AECOPD) patients complicated with community-acquired pneumonia (CAP). METHODS A total of 400 AECOPD patients who were complicated with CAP and treated in Kailuan General Hospital from Jan. 2021 to Dec. 2024 were recruited as the research subjects and were divided into the improvement group with 192 cases and the exacerbation group with 208 cases according to the treatment outcomes 2 weeks after the admission to the hospital. The clinical data， SII， SIRI， and serum inflammatory factors were compared between the two groups of patients. Multivariate binary logistic regression analysis was performed for the influencing factors for the prognosis of the AECOPD patients complicated with CAP. The values of SII and SIRI combined with the serum inflammatory factors in assessment of the prognosis of the AECOPD patients complicated with CAP were evaluated by using receiver operating characteristics (ROC)curves. RESULTS The levels of SII， SIRI and multiple inflammatory factors of the exacerbation group were higher than those of the improvement group (P＜0.05). The age， course of disease， complication with other types of diseases， number of times of exacerbation of COPD within 1 year， COPD and asthma physiology score (CAPS)， and CURB-65 score were the risk factors for the prognosis of the AECOPD patients complicated with CAP (P＜0.05)， while the GOLD lung function classification and 25-hydroxyvitamin D (25OHD) were the protective factors (P＜0.05). The areas under the curves (AUCs) of SII and SIRI in assessment of the prognosis of the AECOPD patients complicated with CAP were 0.803 and 0.848， respectively， and the AUC of SII and SIRI combined with multiple inflammatory factors was 0.963， higher than that of the single indicator (P＜0.05). CONCLUSIONS The AECOPD patients complicated with CAP show high levels of SII and SIRI， and the two indicators can be used as biological indicators for assessment of the prognosis of the patients. The combination with other inflammatory factors may raise the value in assessment of the prognosis of the AECOPD patients complicated with CAP.