Structural equation modeling the “control of gut overgrowth” in the prevention of ICU-acquired Gram-negative infection

Hurley, James C.

doi:10.1186/s13054-020-02906-6

Critical Care

Table 2 Development of the GSEM model

From: Structural equation modeling the “control of gut overgrowth” in the prevention of ICU-acquired Gram-negative infection

	Model 1	Model 2	Model 3	Model 4	Model 5	Model 7	Model 6
	Fig S8	Fig S9	Fig S10	Fig S11	Fig S12	Fig S14	Fig S13	95% CI
Factor^{a,b,c,d,e,f,g,h,i}
b_Ps_n
*Pseudomonas* gut overgrowth	1	1	1	1	1	1	1	Constrained
ppap			1.11**	0.97**	0.97**	1.00**	0.95**	0.27 to 1.61
_cons	− 5.18***	− 5.19***	− 5.38***	− 6.00***	− 6.00***	− 6.05***	− 6.05***	− 6.6 to − 5.4
b_Ac_n
Acinetobacter GO	1	1	1	1	1	1	1	Constrained
ppap			0.6	0.46	0.48	0.44	0.47	− 0.51 to 4639
_cons	− 6.74***	− 6.74***	− 6.83***	− 7.38***	− 7.44***	− 7.47***	− 7.47***	− 8.0 to − 7.0
v_Ps_n
Pseudomonas gut overgrowth	0.67***	0.67***	0.71***	0.80***	0.80***	0.81***	0.81***	0.51 to 1.09
mvp90	0.55*	0.54*	0.49*	0.43	0.43	0.48*	0.49*	0.03 to 0.92
non_D	− 0.37*	− 0.58***	− 0.61***	− 0.60***	− 0.60***	− 0.54***	− 0.54***	− 0.79 to − 0.31
_cons	− 3.63***	− 3.63***	− 3.56***	− 4.17***	− 4.17***	− 4.24***	−4.25***	− 4.7 to − 3.7
v_Ac_n
Acinetobacter gut overgrowth	0.73***	0.73***	0.74***	0.83***	0.83***	0.83***	0.83***	+ 0.66 to 1.01
mvp90	0.79*	0.79*	0.73	0.71	0.69	0.71	0.7	− 0.12 to 1.55
non_D	− 0.35	− 0.31	− 0.33	− 0.27	− 0.21	− 0.17	− 0.17	− 0.56 to 0.23
_cons	− 5.13***	− 5.13***	− 5.06***	− 5.79***	− 5.85***	− 5.88***	− 5.87***	− 6.8 to −4.9
Pseudomonas gut overgrowth
TAP	− 0.65**	− 0.65**	− 0.67***	− 0.68***	− 0.68***	− 0.47*	− 0.57***	− 0.91 to − 0.29
a_S	− 1.34***	− 1.33***	− 1.20***	− 1.01***	− 1.00***	− 0.94***	− 0.93***	− 1.46 to − 0.46
eap						− 0.21
ppap	0.27	0.27
non_D	−0.33
los7				1.03***	1.03***	0.96***	0.97***	0.53 to 1.45
trauma50					0.04	0.03	0.02	− 0.33 to 0.36
CC						0.56**	0.56**	0.08 to 1.10
Acinetobacter gut overgrowth
TAP	− 0.25	− 0.25	− 0.27	− 0.27	− 0.5	− 0.58	− 0.43	− 1.04 to 0.15
a_S	− 1.26*	− 1.27*	− 1.21*	− 1.04*	− 0.85	− 0.8	− 0.82	− 1.83 to 0.19
eap						0.25
ppap	0.1	0.1
non_D	0.06
los7				1.15***	1.01***	0.99***	0.98***	0.41 to 1.54
trauma50					1.09***	1.04***	1.04***	0.47 to 1.62
CC						0.42	0.42	− 0.22 to 1.22
Error terms
var(e.Ps_GO)	1.32*	1.32*	1.17**	0.76**	0.76**	0.71**	0.72**	0.36 to 1.47
var(e.Ac_GO)	2.66***	2.66***	2.56***	1.92***	1.62***	1.60***	1.60***	1.01 to 2.48
Model fit^j
AIC	3345.94	3344.15	3329.29	3274.57	3261.55	3259.1	3255.53
N	22	20	20	22	24	28	26
Groups (n)	334	334	334	334	334	334	334
Clusters (n)	213	213	213	213	213	213	213

*p < 0.05; **p < 0.01; ***p < 0.001
^av_ps_n is the count of Pseudomonas VAP; v_ac_n is the count of Acinetobacter VAP; b_ps_n is the count of Pseudomonas bacteremia; and b_ac_n is the count of Acinetobacter bacteremia
^bPPAP is the group-wide use of protocolized parenteral antibiotic prophylaxis; TAP is topical antibiotic prophylaxis; eap is enteral antibiotic prophylaxis
^ce.Ac_GO is the error term for the Acinetobacter gut overgrowth latent variable
^de.Ps_GO is the error term for the Pseudomonas gut overgrowth latent variable
^eMVP90 is the use of mechanical ventilation by more than 90% of the group
^fLOS7 is a mean or median length of ICU stay for the group of 7 days or greater
^gTrauma ICU arbitrarily defined as an ICU for which > 50% of admissions were for trauma
^hCC is the concurrency of control groups with an intervention group receiving TAP
ⁱLess than 90% of the group receiving prolonged mechanical ventilation.
^jModel fit; AIC is Akaike’s information criteria. This indicates model fit taking into account the statistical goodness of fit and the number of parameters in the model. Lower values of AIC indicate a better model fit. N is the number of parameters in the model

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