Abstract:

Objective To evaluate the associations and predictive value of admission serum calcium，C-reactive protein （CRP），and D-dimer （D-D） levels for disease severity in children with acute pancreatitis （AP）. Methods We retrospectively analyzed clinical data from 71 pediatric patients diagnosed with AP at our hospital from December 2021 to August 2025. Patients were classified by AP severity. Admission serum calcium，CRP，and D-D levels were compared between mild and severe groups. Spearman correlation assessed relationships between these biomarkers and AP severity. Receiver operating characteristic （ROC） curve analysis was used to evaluate the predictive performance of each marker. Results Serum calcium was significantly lower in the severe group than the mild group （1.9±0.5 mmol/L vs 2.2±0.3 mmol/L； P<0.05）. CRP levels were significantly higher in the severe group： Median （IQR） 78.6（24.8，104.5） mg/L vs 3.8（2.3，11.4） mg/L in the mild group （P<0.05）. D-D was significantly higher in the severe group： 3.1（1.7，8.1） mg/L vs 0.5（0.2，1.5） mg/L in the mild group （P<0.05）. Spearman analysis showed serum calcium was negatively correlated with AP severity，while CRP and D-D were positively correlated （all P<0.05）. ROC analysis yielded area under the curve （AUC） values of 0.766 for serum calcium，0.748 for CRP，and 0.741 for D-D （all P<0.05），indicating moderate discriminative ability. Conclusion Admission levels of serum calcium，CRP，and D-D differ significantly among pediatric patients with AP and correlate closely with disease severity. These biomarkers can serve as good indicators for assessing AP severity and for predicting clinical prognosis.

Key words: pancreatitis, serum calcium, C-reactive protein, D-dimer, correlation, prognosis