Predictive Value of Platelet-to-Lymphocyte Ratio (PLR) for Recurrent Small Intestinal Bleeding: A Single-Center Retrospective Study

Background Recurrent small intestinal bleeding challenges clinical management. The platelet-to-lymphocyte ratio (PLR) has not been wel-studied in this context. This study aims to assess the link between PLR and 1 - year recurrent small intestinal bleeding risk after the initial episode. Methods This single-center retrospective study included 131 patients who underwent endoscopy and were diagnosed with small intestinal bleeding for the first time at the First Affiliated Hospital of Nanchang University between January 2019 and January 2024. Clinical data, including demographic information, laboratory results (with a focus on PLR values), and detailed endoscopic findings, were extracted from the hospital's electronic medical records. The occurrence of recurrent bleeding within one year after the initial episode was systematically tracked and recorded. Results Multivariate logistic regression analysis revealed that the PLR was an independent risk factor for recurrent small intestinal bleeding within one year after the initial episode. Elevated PLR levels were significantly associated with an increased risk of recurrence. Notably, PLR demonstrated superior predictive value for recurrence between 10 and 12 months post-bleeding. Restricted cubic spline analysis further confirmed a significant positive correlation between PLR and the risk of recurrent small intestinal bleeding, with the recurrence risk showing a steady upward trend as PLR values increased. Additionally, a clinically relevant PLR threshold was identified: when PLR exceeded 182.3, the risk of recurrent small intestinal bleeding significantly increased. This threshold may serve as a valuable reference for clinicians in assessing recurrence risk. Conclusions This study highlights the potential of PLR as a predictive biomarker for recurrent small intestinal bleeding within one year after the initial episode. By identifying high-risk patients based on PLR values, clinicians can develop more targeted preventive strategies and optimize follow-up intervals, ultimately improving the prognosis of patients with small intestinal bleeding.