UPMC Horizon hospitals in Farrell and Greenville will soon be part of a nationwide study on the genetic triggers of sepsis.

The 18-month study, entitled, "The Genetic and Inflammatory Makers of Sepsis," kicks off at the Horizon hospitals on June 1, said Dr. Jeffrey Moldovan, medical director of emergency services at UPMC Horizon and principal investigator of the study at the hospital.

Thirty hospitals in four states are participating, Moldovan said, with Horizon as the only hospital in northwestern Pennsylvania taking part.

The study, funded by the National Institute of Health, is a follow-up to the Community Acquired Pneumonia study, Moldovan said. This is the fourth major study at the hospital that Moldovan has been principal investigator for, he said.

Sepsis is an overwhelming bodily infection in which bacteria and toxins invade the bloodstream, Moldovan explained. Sepsis, which has a 30 percent mortality rate, affects 450,000 Americans a year.

If one of your parents died from sepsis, Moldovan said, your risk of dying of sepsis is five times greater.

Pneumonia is the most common cause of sepsis, Moldovan said. Out of all patients hospitalized with pneumonia, 75 percent come through the emergency department. Virtually all sepsis diagnoses come through the emergency room, Moldovan said.

Patients who will be enrolled in the study must meet three inclusion criteria: they must be older than 18, they must have a working diagnosis of pneumonia and they must have a chest X-ray to confirm the diagnosis, Moldovan said.

If an emergency room patient is diagnosed with pneumonia, meets the inclusion criteria and does not meet any of the 10 exclusion criteria, the patient will be asked for written consent to participate in the study, Moldovan said.

Patients enrolled in the study only have to agree to having two extra tubes of blood drawn during routine blood work and a brief, follow-up telephone call from a University of Pittsburgh physician 30 days after discharge, Moldovan said.

The goal of the study is to determine if there is a correlation between genetics and inflammatory molecules and sepsis, and to see if doctors can prevent the risk of developing sepsis, Moldovan said.

Besides genetics, researchers are looking at whether certain inflammatory molecules play a role in the development of sepsis, Moldovan said. Studying these molecules may provide a key in predicting who will develop sepsis, he said.

"We're hoping certain numerical levels will help us determine if someone will develop sepsis," Moldovan said.

Currently, there is no blood test to confirm that a patient has sepsis. Doctors make a clinical diagnosis based on physical symptoms, which include fever, a source of infection such as pneumonia or a urinary tract infection and vital sign changes, such as blood pressure or pulse.

Blood cultures can determine if infection is present in the bloodstream, Moldovan said, but results take 48 hours.

"We want to see if we can correlate clinical findings ... If we can take clinical conditions and determine who will need special blood tests ordered and see if we can predict who would go on to develop sepsis, and see if we can prevent the cascade of sepsis," Moldovan said.

The "cascade" of sepsis includes a progression from sepsis, to septic shock, to organ failure and to death, Moldovan said. While sepsis itself only has a 30 percent mortality rate, the mortality rate for septic shock is 80 percent, Moldovan said.

Sepsis can be treated with antibiotics, but once a patient goes into septic shock other agents have to be added to treat blood pressure, Moldovan said. As sepsis patients decline, they may have to be put on advanced cardiac life support.

"The problem with sepsis is once a patient starts that cascade, there's very little we can do to stop it," Moldovan said.