Special Considerations Related to Race, Sex, Gender, and Socioeconomic Status in the Preoperative Evaluation: Part 2: Sex Considerations and Homeless Patients.

Preoperative evaluation identifies unique patient characteristics with an impact on perioperative care. Sex-based differences in cardiovascular disease are particularly important. Diseases in women can go unrecognized and yet have long-term implications for cardiovascular risk. Peripartum cardiomyopathy and hypertensive disorders of pregnancy affect cardiovascular risk in young women long after pregnancy. Sex-hormone therapy in women, men, and transgender patients carries minimal perioperative risk, except in select patients at high risk for venous thromboembolism. The unique challenges facing patients experiencing homelessness in accessing care mean underlying comorbidities are common and additional resources may be required to provide effective perioperative care.