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Spectrum of injuries resulting from gunshot wounds in car hijacking: a South African experience
  1. Victor Kong1,2,
  2. Ross Weale3,
  3. Joanna Blodgett4,
  4. John Bruce2,
  5. Grant Laing2,
  6. Damian Clarke1,2
  1. 1 Department of Surgery, University of the Witwatersrand, Johannesburg, South Africa
  2. 2 Department of Surgery, University of KwaZulu Natal, Durban, South Africa
  3. 3 Department of Surgery, North West Deanery, Manchester, United Kingdom
  4. 4 Department of Epidemiology, University College London, London, United Kingdom
  1. Correspondence to Dr Victor Kong, Department of Surgery, University of the Witwatersrand, 29 Princess of Wales Terrace, Parktown, Johannesburg, 2193, South Africa; victorywkong{at}


Background Car hijacking, known as “carjacking”, is a form of aggravated robbery of a vehicle from the driver frequently involving firearm and is common in South Africa. There is, however, little literature on the spectrum of injuries sustained by victims of car hijacking. The study aimed to describe the spectrum of gunshot wound-related (GSW) injuries and review our experience of management of victims of car hijacking in our trauma center based in South Africa.

Methods A retrospective review was conducted during an 8-year period from January 2010 to January 2018 on all patients who presented with any form of GSW after a car hijacking incident.

Results During the 8-year study period, a total of 101 patients were identified. Seventy-four percent were male (75 of 101) and the mean age was 34 years. The mean time from injury to arrival at our trauma center was 7 hours (rural district: 10 hours, urban district: 4 hours; p<0.001). Seventy-five percent (76 of 101) of all patients sustained GSWs to multiple body regions, whereas the remaining 25% (25 of 101) were confined to a single body region. The most common region involved was the chest (48 cases), followed by the abdomen (46 cases) and neck (34 cases). Sixty-three of the 101 (62%) patients required one or more operative interventions. The most common procedure was laparotomy (28 cases), followed by vascular (20 cases) and neck (14) exploration. Eighteen percent (18 of 101) of all patients required intensive care unit admission. The mean length of hospital stay was 7 days. The overall morbidity was 13% (16 of 101) and the overall mortality was 18% (18 of 101).

Discussion The spectrum of injuries from GSW related to car hijacking commonly involves close range GSWs to multiple body regions. Torso trauma is common and a substantial proportion of victims require major operative interventions. The mortality from these injuries is significant.

Level of Evidence Level III.

  • Gunshot wound
  • Car hijacking
  • Injury spectrum

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  • Contributors Dr Victor Kong conceptualized and designed the study. All authors contributed to the writing of this article and the author order is reflective of the time commitment.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Disclaimer Victor Kong, John Bruce, Grant Laing and Damian Clarke are current Advanced Trauma Life Support instructors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval Ethics approval for the maintenance of the regional electronic trauma registry for both clinical care and research has been formally endorsed by the Biomedical Research Ethics Committee (BREC) of the University of KwaZulu Natal (UKZN). (IRB Approval Reference: BE 207/09)

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Any requests for the original data are welcome and should be directed to the corresponding author.

  • Author note This paper was presented by Dr Victor Kong as an oral presentation at the 4th World Trauma Congress, San Diego, California, USA on 28th September 2018.

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